Access American is a longtime and reliable provider of medevac insurance. I have purchased TC&II (Trip Cancellation and Interruption Insurance) from Access American myself, and they are quite reputable. I doubt - highly - AA is selling "scam insurance."

I'd have to check the entire wording / T&Cs to see what you are speaking of, but I'll just suggest you be sure you aren't talking about apples and oranges. "Medical repatriation" means returning you to your country of residence for medical treatment; "emergency medical transportation" generally means to the nearest medical facility that can provide competent treatment.

(If medical transportation and treatment in emergencies is your primary interest, check Divers Alert Network at www.dan.org for inexpensive, yearlong coverage for members; you neither have to be a diver nor any particular age to be a member.)