Fly Flat Seating Jargon in Aircraft Configuration - Why it Matters

What you should know before you plan your next international business class flight reservation


At Medical Tourism Journeys, our Medical Tourism Journey Manager® advise all your options. One thing we take seriously is your safety and comfort while flying to and from your medical tourism destination. We know first hand what can and does happen when a person flies often and flies long distances.

Mercury Healthcare International CEO, Dr Maria Todd flies about 300,000 air miles each year to attend international conferences as the featured keynote speaker on medical tourism business and destination development topics, medical tourism safety and quality management, and to present workshops and provide consultation to our clients of the firm.

In the past 3 years, all this flying and time at high altitudes has taken its toll on her health. She has suffered three episodes of deep venous thrombosis since 2010 and two life threatening episodes of pulmonary embolism (where her clots traveled from her legs to her lungs). In one case, she was hospitalized in Spain for nine days because of the condition.  In another, she was hospitalized upon her return home in Denver for five days.  As a result, all her travel is arranged in "fly flat" seats for all flights in excess of 3 hours, by doctors' orders. Otherwise, she simply doesn't travel.  She also now requires expensive medication for life (at a cost of about $480 per month, in the US).  

This is why we are so sensitive about how our clients at Medical Tourism Journeys are booked for air travel to faraway destinations. Besides health and safety, we also want our clients to be as comfortable as possible during their travel. For this reason, our travel agency partner offers our employees, consultants and guests exclusive discounts of up to 60% on international business class air travel fares. With the discount, the difference between flying coach and business class on international trips is more affordable for our consulting clients and our medical tourism clients.

Here are some expert tips you should know about before planning a long distance medical tourism journey by air.

First, and foremost, fly flat seats are not new. Back in the 1930s and 1940s, Pan Am’s Boeing 314 Clipper “Flying Boats” had actual beds, as did British Airways (BA) predecessor, BOAC, which also operated 314s. Fully horizontal beds re-appeared in first class international seats in 1996. In 2000, British Airways launched Club World Business Class, which was updated again in 2006.  These seats may be considered fully horizontal, but according to Maria, there are now many more options in the sky.  Her most recent Club World Business Class flight from Denver to London and on to Bangalore and back left her in pain with sciatica and shooting pains in her buttocks and down her leg following the course of the huge sciatic nerve that runs from the low back to the big toe.  She was so uncomfortable after the landing at Heathrow in London on the way home, she found it necessary to break her journey and find a hotel and pain relief to be able to continue.  Why?  "The seats were so low, they were like the little squatty sand chairs you see at the beach, and the surface of the fly flat bed was hard enough to bounce a quarter off it. Anyone with a leg, back or hip or shoulder or wrist injury or recovering from orthopedic, neurological, abdominal surgery or currently pregnant would be better off on another airline."

British Airways is now preparing to redesign and reconfigure its business class product, but the change won't likely occur before 2019 with the introduction of its new 787-10 Dreamliner Airbus A350. Too little, too late. 

Lie flat vs Angle Flat

Angle flat seats cause many people discomfort because they slide down. Gravity pools the blood in one's legs causing swelling at the ankles and then the swelling works its way up the leg until you feel like someone inflated the tissue under your skin to the point where your clothes feel constricted. When we do your travel planning, your Medical Tourism Journey Manager ® checks to determine in advance which flights plan to fly which aircraft. If you are doing this for yourself without the assistance of a Journey Manager® or travel agent, you can check the flights you are interested in on That's actually as close to reality as you can get. The problem is, sometimes there are mechanical or weather issues that cause the airlines to make a quick substitution of an aircraft that doesn't have the same configuration as planned. 

Many international route aircraft have seats that are adjustable. They allow the passenger to choose any incremental position from fully upright to angle or full horizontal flat bed surface. Some offer heat and massage. Others, like Singapore Airlines, Virgin Atlantic and Air New Zealand have a flip down model. Flight attendants help you prepare your "bed" for sleeping and sometimes offer mattress pads, comforters, and pillows for use in flight. Qatar Airways and a few other airlines, also offer soft, comfortable pajamas to change into before retiring during the flight.  We also offer our clients "Flyjamas" that they can wear with all modesty during long flights to and from their medical tourism journey destination. They are similar to the medical scrub pants and shirts you see doctors and nurses wearing, but have our logo on the pocket of the shirt. Our clients love these and treat them as souvenirs of their medical tourism journey experience with us.

Aisle Access

Many of the airlines configure their business class cabin in such a way that you must disturb your fellow passenger to get up to stretch your legs. This is critical. Our medical advisers encourage us to remind our clients to get up each hour for a walkabout, and to drink water to mitigate the risk of DVT and pulmonary embolism. That's difficult to do if you have to jump over the passenger in the next seat or worse, wake them up from a nap.  As a result, we seek aircraft configurations for our long haul passengers that offer all aisle access seating (1-2-1). The next best thing is a 2-4-2 staggered configuration so that you won't have to step over your seat mate to get up.  This 2-4-2 configuration is available on Emirates A380 aircraft.


How we can help you

Medical Tourism Journeys planners customize the all-inclusive experience for individuals, couples, families and groups by selecting different levels of luxury and service to meet our clients' requirements. Those with a modest budget opt for basic packages at a lower cost, while luxury-seekers can book bigger suites and pay for added services and amenities.  We tour each one before adding them as Approved Providers in our Network. They must pass our rigorous standards and criteria. our Approved Spas and Resorts include both upscale adults-only properties and family properties where travelers with children are staying.

Our clients tell us that they don't want to or don't have time to deal with the logistics of organizing a mass-scale trip or figuring out what to do if something goes wrong. Our specially-trained travel planners share their personal experiences and their resort knowledge. They leverage resort destination contacts and stay three steps ahead using experience to sidestep avoidable problems. It takes an experienced travel planner to coordinate travel logistics for health and wellness journeys, especially when the group is traveling from different locations and airports on different airlines, using frequent flyer reward miles, and need special planning for wheelchairs, strollers, and other necessities. They trust our Approved Provider choices rather than take a chance with their own research on the Internet. Our clients know that someone is on duty around the clock if there's a problem, and if they need anything, they call us. We also make arrangements with the hotel so that risks of reservations not being honored because a previous guest didn't check out don't happen. That's not something an individual traveler can do on their own. But the main thing we do at Medical Tourism Journeys is listen to what our clients want and do everything in our power to make it happen.  That pays off in repeat business and excellent referrals to friends and families. Over the past 35 years, that's how we've grown our business to what it is now. 

Medical Tourism Journeys offers care coordination and complete travel planning to medical, wellness, dental and pharmacy tourism destinations all over the world.

We leverage our long established history and high volumes of travel arrangements to get your discounts that aren't available at other medical tourism websites. Approved healthcare and wellness providers are coupled with Approved Hotels in our network at various destinations around the world. When you call, you can inquire about our upcoming group and private tour packages for surgery, consultations, dialysis, spa and wellness programs to appealing destinations. Then let your Medical Tourism Journey Manager® advise all your options. We never just tell you to "get your own tickets" online or through a local travel agency. We have this policy for your safety, comfort and convenience. We don't make money on air travel reservations. What you pay goes directly to the airline. But we do it because it's the right thing to do.

Medical tourism travel planning and patient movement takes specialized training.

We choose the appropriate seating, meals and make arrangements throughout your entire flight itinerary for wheelchairs, oxygen access, storage of crutches or walkers inside the cabin, avoiding stairs, and connecting from flight to flight at huge international airport hubs that may require more than a mile walk to the next gate.

Your Medical Tourism Journey Manager® briefs you on what to expect, if you should have tip money ready for assistants, and if so, how much. They also make sure you have enough time to connect to your next flight if the wheelchair assistant is late arriving to collect you when the flight arrives without expecting you do sprint to the next flight if you are temporarily incapable of that kind of activity during your post-operative period.

Contact us any time, 24 hours per day to learn more about the tours we offer throughout the world several times each year for health and wellness and pharmacy tourism.

We arrange medical tourism journeys for your convenience wither you choose to travel with a group or alone, as a couple or as a family.  Your companion travelers are always welcome to join the group whether plan to visit with the doctor or just to participate on the tourist activities. Your Medical Tourism Journey Manager® will organize everything for you in advance - appointments, tours, hotels, transfers, and medical visits to the doctor and the pharmacy and an interpreter, if needed.  Ask about the kinds of tour packages we offer - from sedentary to active. Many of the activities on our tours are outdoors and may include hiking, biking, riding and climbing. At seasonal destinations, skiing is also available. Please advise your Medical Tourism Journey Manager® of your preferences when you call.

Your Medical Tourism Destination Coordinator will always be nearby and accessible from the time you land until the time you are ready to board your return flight home. While in flight, our travel coordinators keep an eye on your journey itinerary to take action if you miss a flight, are delayed or something else happens that may require rebooking or re-accommodation on a different flight and a hotel booking for a long layover.

Every Approved Hotel stay includes free Wi-Fi and strong internet connections. For smaller groups and family tours, we organize luxurious, private chauffeur-driven black sedans to carry you from place to place at your destination.  We also choose properties and tourism suppliers who will make you feel comfortable when you want to fall back on authentic comfort foods, native language TV and culturally aware staff to give you a break from the spectacular sights and sounds of the selected destination of your visit.

Payment for your Procedure and Medical Travel

Your Medical Tourism Journey Manager® also helps with payment arrangements. We would be pleased to verify with your insurance plan to determine in advance if your consultation with the doctor and your prescription costs (and possibly your related travel costs) will be covered by your insurance or employer. If the response is positive, your Medical Tourism Journey Manager® will obtain pre-authorization and pre-certification as may be required by your insurer.  If your insurer will not cover the procedure, Approved Providers and the Approved Pharmacies accept cash, check or credit card at the time of service or purchase.  Some of our US providers also participate in various financing programs - so please ask us what is available if special medical travel financing for your trip and medical procedure expenses would be helpful.

Learn more about how we can help you arrange your next medical tourism journey package.  Just complete the simple form below and one of our Medical Tourism Journey Managers® will follow up with you or your loved ones to get everything arranged in short order.

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