03 Aug When Time Matters- Air Medical Transportation
You have major medical insurance. You opt for the absolute best coverage available to you and your family. You budget and pay monthly premium. You feel safe knowing if someone in your family has a medical emergency you know that you are covered. You know your deductible, your co-payments and your maximum out of pocket. You are prepared for an emergency. You are covered.
You are cooking dinner one night and start having bad pain in your chest. You call the hospital, they tell you to come to the ER. You grumble, but head into the hospital. They run tests. While you are waiting for results a registrar enters your room to go over all of your insurance information. You give a lovely person your insurance card knowing that you are covered.
Suddenly, the doctor enters the room with several nursing staff members. You are told that you are having a major heart attack. You need emergency surgery to get blood flowing to the parts of your heart where there is currently no blood going. Time is of the essence. Every second counts. You need to be flown to a larger hospital where they can perform the specialized operation. The flight team is already activated and will be here in minutes. A million thoughts start cascading through your head. How will you pay for this flight is most likely not one of those thoughts.
After a month this event is still fresh in your mind as you are opening the bills from all of the different doctors, specialist and facilities that you visited. One more EOB (if you don’t know what this means you are in luck! Stay tuned for part 3 of this series!) for the ever-growing pile. You open a bill that shows a balance due of $30,000*. You know that you have insurance so you aren’t too concerned. You continue reading to find that your insurance has already paid $5,000 and the remaining $30,000 is due. You are confused and worried as you call the number listed.
You are told that the air ambulance company is out-of-network. You have used the entirety of your our-of-network insurance benefit and will owe the air transportation company $30,000.
This sounds like fiction, something that should not happen, right?
Okay, that’s a lot of technicalities. If you have questions about in-network and out-of-network part 2 of this series will be an in-depth dive into what all of this contracting means to you. If you want to learn more just ask! We are here to help you!
Although this sounds crazy most medical aviation transportation services are not regulated by the state insurance regulations. Yep, they can bill you whatever they deem reasonable, regardless of your insurance coverage. Most air medical transportation companies say that they are unable to reach an adequate compensation agreement with insurance carriers; they have to cover costs too.
This article was not written in an attempt to make a bad guy out of the air medical transportation industry. We need them. They save lives every day. Roughly 30% of the population depends on air transportation for access to urgent medical treatment.
That being said we also need to be aware of a massive gap in this system and how to protect your assets. After all, that is what insurance is all about!
To fill this gap there are companies that offer membership to help in case of an emergency transportation. You can protect yourself by becoming a member of an air transportation program. These memberships serve to protect your employees, family and yourself for less than $50 a month**. We can help you find a membership program that would work for you. We can also explain all of the benefits.
*This is a hypothetical cost analysis. Although some transportation costs average $15,000-$50,000, actual costs vary. Every insurance plan varies in the amount that will be paid toward emergency medical transportation. If you have questions on your specific plan call your insurance carrier or broker.
**Rates may vary