Flying private with medical needs

People charter for medical reasons more often than you might expect: to come home after an operation abroad, to travel with an oxygen concentrator without an airline’s paperwork, or to get an elderly parent somewhere without a long walk through a terminal. A private aircraft can make those trips easier. The rules are mostly about equipment, and the line that matters is between a passenger with a medical need and a patient who needs care in flight.

Can you bring a portable oxygen concentrator on a private jet?

Yes, if the device meets the FAA’s criteria and the operator agrees. 14 CFR 135.91(f) says a certificate holder “may allow” a passenger to carry and use a portable oxygen concentrator (POC) during all phases of flight if the device:

• is legally marketed in the United States under FDA rules;
• does not interfere with the aircraft’s systems;
• generates oxygen at less than 200 kPa (29 psi) gauge pressure;
• contains no hazardous materials beyond the batteries allowed for portable electronic devices; and
• carries a permanent label, in red, stating that the manufacturer has determined it “conforms to all applicable FAA acceptance criteria for POC carriage and use on board aircraft”. Some older models approved before May 24, 2016, such as the Inogen One and Respironics SimplyGo, are listed by name instead.

The operator must also make sure the device is stowed for taxi, takeoff and landing, and that the person using it does not sit in an exit seat or block an exit or the aisle.

What to send the operator: the make and model, a photo of the label, how long the batteries last, and how many spares you will bring. Spare lithium batteries go in the cabin; what you can bring on a private jet covers the battery rules.

Can you bring medical oxygen cylinders?

Only under conditions. 14 CFR 135.91(a) lets an operator carry equipment for storing or dispensing medical oxygen if it is of an approved type or meets the Department of Transportation’s hazardous materials rules, is secured, is free of flammable contamination, and has its valves and gauges protected. The pilot in command must be told it is on board and when it will be used. No one may smoke or create an open flame within 10 feet of it, and only someone trained in the equipment may connect or disconnect the bottles while passengers are aboard.

In practice, ask the operator early whether it will carry your oxygen, supply its own, or neither. It is an equipment question, and the answer differs between operators.

There is a narrow exception in 135.91(d): in a medical emergency, when no other practical transport is available, an operator may carry oxygen equipment furnished by a professional medical service, if a person trained in its use travels with the patient. The operator must report the deviation to the FAA afterwards.

When do you need an air ambulance instead of a charter?

When the patient needs to lie on a stretcher, needs medical care in flight, or needs medical equipment installed in the aircraft. That is an air ambulance flight. The FAA authorizes it separately: an operator conducting airplane air ambulance flights needs operations specification A024, and its crews must complete air ambulance training first.

A useful way to think about it:

Situation	What it is	Who flies it
A passenger with a walker, a wheelchair or a POC	An ordinary charter	Any Part 135 operator that accepts the equipment
A passenger travelling with a nurse as a companion	An ordinary charter	As above; the nurse is a passenger
A patient on a stretcher, or who needs monitoring or treatment in flight	An air ambulance flight	An operator authorized for air ambulance operations
A medical emergency	An air ambulance, arranged by a medical provider	An air ambulance operator

If you are not sure which you need, ask the treating doctor or hospital.

Is flying safe after surgery?

That is your doctor’s decision. What a charter can tell your doctor is the cabin altitude: the pressure inside the cabin, expressed as an altitude, which affects how much oxygen your blood absorbs and how gas in the body expands.

For transport-category aircraft, 14 CFR 25.841 requires a cabin altitude of no more than 8,000 feet in normal operation. Many business jets are pressurized to lower cabin altitudes, and manufacturers publish them:

Aircraft	Published cabin altitude	Source
Gulfstream G700	2,840 ft at 41,000 ft	Gulfstream
Bombardier Challenger 3500	4,850 ft	Bombardier
Embraer Phenom 300E	6,600 ft maximum	Embraer
Transport-category limit	8,000 ft	14 CFR 25.841

The figure varies with the altitude the aircraft is flying at. If your doctor sets a limit, tell the operator, which can tell you whether the trip can be planned at a lower cruising altitude.

What should you tell the operator before a medical trip?

1. The equipment: POC, oxygen, CPAP, wheelchair or walker, with makes, models and batteries.
2. Mobility: whether the passenger can climb the aircraft’s steps. Doors and airstairs differ a lot between aircraft, and a larger aircraft may suit better.
3. Any doctor’s limit on cabin altitude or flight time.
4. Who is travelling with the passenger, and whether they will give any care on board.
5. The ground at both ends: a car or ambulance to the aircraft, if the FBO allows it.

What Jake checks

Jake asks about medical needs when the trip is booked, because they decide the aircraft: the door and steps, the cabin altitude and whether the operator will carry the equipment. He sends the operator the equipment details in advance and gets its agreement in writing, so the conversation does not happen at the aircraft. If the trip needs an air ambulance, he will tell you so rather than book a charter.

To plan a trip, call +1 (862) 485-3510 or request a quote, and describe the medical need in the notes.

Sources

• 14 CFR 135.91, Oxygen and portable oxygen concentrators for medical use by passengers (eCFR, Title 14)
• 14 CFR 25.841, Pressurized cabins (eCFR, Title 14)
• FAA Order 8900.1, Volume 4, Chapter 5, Section 2: air ambulance operations (OpSpec A024)
• Gulfstream: G700 specifications
• Bombardier: Challenger 3500
• Embraer: Phenom 300E brochure