This coverage may be included in health insurance or travel insurance. Look at your travel or healthcare plan in advance to choose the one that offers it with the lowest out-of-pocket costs and deductibles, as well as the co-insurance terms that work best for you.
What Is an Air Ambulance?
An air ambulance is also known as a “medical air transport.” It’s any form of aircraft equipped with supplies, equipment, and qualified medical professionals that will provide mobile care during transport. Air transport may be by helicopter or by airplane. Its mission is to ensure the best care during transport to a medical center that can best deal with your condition, injury, or illness. Air ambulances are used when time is of the essence. It is helpful if you’re injured during a trip and would like to receive care near your home, if you must go to a distant facility for specialized treatment, or if you have to be transported to a rehabilitation center for specialized care. It can get you help fast if being transported by ground is impossible or will provide a risk to your health. The air ambulance may take you to the nearest facility, depending on your health coverage, or it may take you all the way home if your contract provides for a higher level of coverage. That is where fully understanding the coverage you’ve purchased becomes essential. Think about the kinds of activities or places you will travel to.
How Much Does It Cost?
According to the Health Care Cost Institute, air transport costs increased by 144% for helicopters from 2008 through 2017, the time of the last comprehensive study. The average cost was $27,894 in 2017, which increased by 166% for planes, to $41,674 in the same year.
When Is It Covered by Health or Travel Policies?
Air transport can be covered by health or travel policies when the emergency doctor recommends it due to being medically necessary. It can also be covered if you receive a letter of medical necessity.
Definition of “Medically Necessary”
Medically necessary refers to the care needed to prevent, diagnose, or treat an illness, injury, condition, or disease by current standards. This type of healthcare can refer to either services or supplies. Air transport may be contacted to come to you quickly if you’ve been in an accident or if you might not survive a trip in a land ambulance. The air ambulance has medical professionals on board, along with a mini-hospital where they can begin treating you as you fly. You may need air transport when the alternatives would be dangerous to your health or would risk the success of a needed procedure. You may need it if you’re bleeding beyond the control of regular services or if you need oxygen, life support, or other aid during transportation. Air transport is often used in cases involving stroke, heart attack, burn care, head or spinal cord injury, and transplant. It’s also common when injury occurs in a remote place where regular transport isn’t accessible or when large distances must be traveled in a short time.
Is Approval Required?
Air transport must still be approved by your health or travel insurance carrier, even if the doctor involved recommends one. A doctor working for your insurance company will review the request. They will decide whether it is necessary by current standards. Your insurer generally must approve the recommendation. or you might not be covered.
Does Insurance Always Cover the Cost?
Many people who have insurance through their employer, Medicaid or Medicare, or a private travel or health insurance plan don’t think twice about an ambulance bill. They think the insurer pays for it, but they could still end up with a hefty bill even in cases where coverage is provided, given the clauses in health and travel plans such as deductibles and co-insurance. You should never assume that the full costs of air transport will be covered. You may end up paying thousands of dollars out of pocket if you don’t check with your insurer first. The costs of air transport stem from the company used, the services provided, and the travel distance.
What Are the Limitations and Exclusions?
Coverage for air transport will vary from state to state and by insurance type and company. You can contact your state insurance commissioner’s office to find out more about the coverages available in your state if you’re unsure. Some companies cite when this coverage may be provided in whole or in part. Some will limit the type of aircraft that’s covered. They may also decide to pay only the portion of the cost that they deem to be “reasonably necessary.” The balance of the bill could be your responsibility in these cases.
Beware of Out-of-Network Services
Make sure your coverage will accept the air transport service you’re using, even if air transport is covered. You might not be reimbursed for the charges if the air ambulance is “out of network,” or you might only be paid up to a certain amount. Ask your insurer about out-of-network air ambulances and what you should do if you need one. According to the National Association of Insurance Commissioners, the service can cost tens of thousands of dollars.
How to Make Sure You Have Coverage
Contact your insurer, employee benefits plan administrator, or your agent to see what air transport coverage you may have. Ask whether you can add extra coverage for an air ambulance if you don’t feel that you have enough. You might also inquire whether you’re covered under a spouse’s health insurance plan or under domestic partner benefits. You could look into reducing costs using coordination of benefits in such cases. You may need to look into another insurance company if you still feel that you need more coverage.
For Emergencies Only?
According to the Association of Air Medical Services, more than 550,000 people use air transport per year in the U.S. It is not always for unplanned medical emergency services. A service could be medically necessary but not urgent. Care may be required during transport, but the timing of the transport isn’t critical. Hospitals often coordinate to transport patients. They can set a schedule to help lower the costs.
Is It Covered by Medicare or ACA?
Medicare or Affordable Care Act (ACA) plans may pay for services like emergency air transport if no other form of transport is available and if it meets the rules for being medically necessary. However, this might be subject to a deductible and to the co-insurance clause of your plan, so you could still end up paying part of the costs out of pocket.
Advance Beneficiary Notice of Noncoverage (ABN)
You may receive an “Advance Beneficiary Notice of Noncoverage” (ABN) if air transport is deemed necessary but not urgent. The ABN will advise you, before you take the service, that you will have to pay for all charges.
Transport of a Companion, Dependent, or Spouse
Insurers will often include coverage for a family member or companion if air transport is covered. Be sure to ask your insurance rep.
Is Air Ambulance Service a Good Idea?
There are many private air transport services available. They’re often geared toward travelers who would like to be able to fly back to their home doctor or hospital to be treated if they happen to need care while they’re away from home. These are great services, but they may not provide for all needs. Contact your insurer prior to making any commitment, or you may find that your claim isn’t approved. Private air ambulance providers often have an insurance-coordination service, so be sure to find out whether they can help you with your insurance and outline what costs will or will not be covered. The best thing to do is to make sure you ask plenty of questions. Read any contracts with care before committing.
