Travelers with medical conditions, special equipment needs or obvious health impairments must beware of travel guidelines set by the Centers for Disease Control and Prevention (CDC). Airlines ‌do‌ have the right to refuse to transport persons demonstrating conditions that may worsen or have grave consequences during the flight -- and they do not hesitate to act on that right. In light of the recent coronavirus pandemic, airlines may be even more strict now than they used to be about sick passengers. Infectious diseases are top-of-mind, and nobody wants to run the risk of becoming sick en route to their final destination. Savvy passengers concerned about an uncomfortable incident at the gate should know what clearances to obtain and what to expect at the airport prior to their check-in date.

Why Passengers Are Refused

If a passenger with an uncontrolled, severe or contagious disease travels by air and requires immediate medical attention during the flight, the aircraft may have to make an unplanned landing. In-flight issues and unplanned landings cause significant scheduling problems and incurred expenses for the airline, the ill passenger and all the other airline passengers on the flight. Airlines do not publish what it costs to divert an aircraft for a medical emergency, but the American Society of Anesthesiologists reports that it's estimated to be between $15,000 and $893,000. For this reason, airlines are extremely reluctant to allow people on-board whose health could result in such an incident. Ultimately, airlines just want to maintain the well-being of their passengers, flight attendants and other crew members.

Refusal Procedure

The refusal process occurs before the plane departs. Members of the cabin crew (i.e. flight attendants) are required to notify the captain if they see any indication that a boarding passenger may be seriously or communicably ill. These indications of communicable disease might include frequent sneezing, severe coughing, sweating and so on. The decision to refuse travel to the sick passenger rests with the captain. According to the World Health Organization (WHO), this decision is based on whether the passenger "is fit to travel, needs medical attention or presents a danger to other passengers and crew or to the safety of the aircraft." If any of those conditions are met, the traveler is refused passage. No laws require airlines to refund the ejected passenger, and policies as to refund and travel credit diverge widely.

Pre Existing Medical Conditions

Air travelers with pre existing health conditions such as cancer, heart disease, lung conditions, diabetes, recent surgery or any other medication-requisite health issue must consider the necessary precautions for safe travel. Hand-carry any medication that must be taken during the journey -- do not put it in checked baggage, as it will be unavailable until the journey's end. Also carry a copy of each prescription in your carry-on. Air travelers with a medical condition that causes the patient to appear obviously ill, necessitates oxygen or requires injections of drugs must apply for a medical card from the airline's reservation department. The card is proof of medical clearance, greatly lessening the possibility of being turned away at the airport. Medical certificates can also be obtained from a doctor to get around health-related travel restrictions.


Although the World Health Organization gives general guidelines regarding conditions that may necessitate advance medical clearance, policies vary between airlines. For example, Delta Airlines may have different rules for transportation than American Airlines or United Airlines. Check your airline's specific requirements before booking the flight. If you happen to become ill after the flight is booked, certainly do so before arrival at the airport.

Note:‌ If proper steps are taken, some airlines may provide a full refund for travel plans that had to be canceled or rescheduled due to illness.