Tommy Lloyd
Author: Tommy Lloyd, Managing Director

Tommy has over 15 years experience within the insurance industry, and his primary focus is helping travellers find the right cover for their medical conditions.

In 2018, over 4 billion air trips were taken worldwide

If you have a health condition, you’ll want to ensure that you’re fit to fly before travelling abroad.

While you might feel well enough within yourself to tackle the journey, it’s always worth checking-in with your doctor so that they can get a better understanding of your condition before you commit to flying. 

However, beyond a routine chat with your doctor, you might find that there are circumstances where you might need an official fit to fly certificate...

General restrictions on flying

Airlines have their own policies and procedures in place when it comes to passengers with medical conditions. 

The general rule of thumb is that airlines can reserve the right to refuse passengers with conditions that could get worse during a flight. 

In most cases, airlines will request medical clearance for conditions that are deemed unstable. 

However, air travel is normally not advised in the following cases (although please bear in mind this list is far from exhaustive and you should consult your doctor if you think you could face restrictions for your condition): 

  • angina
  • any active infectious disease
  • decompression sickness after diving
  • increased intracranial pressure (due to bleeding, injury or infection)
  • sinus infections
  • a recent heart attack
  • a recent stroke
  • recent abdominal trauma
  • recent gastrointestinal surgery
  • recent brain surgery
  • a recent eye operation
  • severe chronic respiratory disease
  • unresolved pneumothorax
  • sickle cell anaemia

It’s also not advised for infants less than 2 days old to travel, or women past their 36th week of pregnancy.

Medical Travel Compared Waiting To Board

When do you need a fit to fly certificate?

A fit to fly certificate is needed in order to be granted medical clearance by your airline. 

If your condition is stable, it’s very unlikely that you will be asked for medical clearance - but a fit to fly certificate may still be required if: 

  • You’ve recently been discharged from hospital
  • You’re in recovery from an operation
  • You’re more than 28 weeks pregnant
  • You’re actually travelling for medical reasons (i.e. you’re going for some treatment)

Of course, whether or not you need a fit to fly certificate is at the discretion of your chosen airline, so you should always carefully check their individual guidelines to find out their specific requirements. 

As far as individual conditions are concerned, here is a summary of different scenarios where a fit to fly certificate might be required by your airline:

Scenario Flight restrictions
Flying when pregnant Most airlines require a fit to fly certificate after 28 weeks. Most airlines do not allow air travel after 36 weeks (or 32 weeks for multiple pregnancies).
Flying while recovering from surgery Varies based on severity of the surgery. Contact your airline and your GP about establishing whether you’re fit to fly.
Flying with a heart condition According to the British Cardiovascular Society guidelines, most people with a heart condition can fly safely, but this varies based on severity of condition. Contact your airline and your GP about establishing whether you’re fit to fly.
Flying with angina Provided symptoms are under control by medication, angina should not be a problem on board an aircraft. However, if you have chest pain while at rest, you may not be able to fly. Contact your airline and your GP about establishing whether you’re fit to fly.
Flying after a heart attack You may be able to travel after 7 to 10 days, provided there are no complications.
Flying after heart failure Provided symptoms are under control, heart failure should not be a problem in flight. However, if you have chest pain while at rest you may not be able to fly. Contact your airline and your GP about establishing whether you’re fit to fly.
Flying with a pacemaker Should not cause problems for travelling by air. However, pacemakers can sometimes set off airport security alarms so be prepared with a letter from your doctor.
Flying after heart surgery Advisable not to fly for at least 10 days after surgery and until you are able to manage normal day-to-day activities.
Flying with high blood pressure High blood pressure should not be affected by air travel, but it is advisable to only travel when your symptoms are under control.
Flying with asthma Those with asthma should not have issues with flying, though it is advisable to always carry any medication such as an inhaler in your hand luggage.
Flying with a broken bone Because of the risk of swelling inside a cast, many airlines choose to restrict flying during the first 24-48 hours after a cast has been fitted. If you do decide to travel before that time period has elapsed you can expect the airline to require your cast to be split along the full length to prevent any pressure buildup impacting your circulation. Having a letter containing the date & time the cast was fitted will be helpful.
Flying with diabetes Air travel should not pose significant problems for travellers with well-controlled diabetes.
Flying with a disability Most people with mobility problems have found it possible to travel by air, especially with legislation which was passed in 2008. If there are other medical issues you should check with your GP that these are taken into account.

Again, it’s important to keep in mind that requirements will differ across different airlines, it’s highly recommended to check on their individual websites prior to travelling. Also remember that your GP has an important part to play in assessing your condition - so be sure to to seek their advice as and when you need it. 

If your airline requires you to provide evidence that you’re fit to fly, this will usually come in the form of a Medical Information Form (MEDIF), of which there are usually two parts (here’s an example). Part 1 is usually filled out by the passenger and Part 2 is filled out by the passenger’s doctor.

How much does it cost to get a fit to fly certificate?

This depends on how much your GP surgery charges - but typically this cost ranges from £20-£40. 

You can find a list of suggested fees from The British Medical Association if you want a more comprehensive idea of the different costs and fees you might expect.

When will my fit to fly certificate expire?

Again, there is no clear cut answer for this. But at the very least, your certificate should indicate that you’re fit to fly at the exact time of your trip. 

So, if you have a letter from months ago - the likelihood is that this won’t be suitable for your airline today. 

If you have a recurring, or more permanent medical issue, it’s probably best advised to get a fit to fly certificate every time you travel - just to be on the safe side.

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