The call for medical flight services is usually left to the professionals who evaluate the situation and make a decision. However, the payment for the medical flight services almost always falls on your shoulders, and this can often turn out to be a huge burden.
What if the $10,000 call for medical flight services was totally unwarranted and you would have only incurred a few hundred dollars if you had opted for ground ambulance services? Here, we discuss a few factors that decide whether medical flight services should be pressed into service or not.
Is the Injury Life-Threatening to Warrant Medical Flight Services?
The concern for your loved ones is understandable but unless the patient is in a life-threatening situation and medical flight services can reduce the risk, there is no point calling for one. One must keep in mind that concern and fear are not the reasons to call medical flight services.
Discuss the extent of the injury with the qualified personnel who takes the call and voice your opinion. At the end of it, it is you who will have to make the payment and insurances won’t pay unless the reason for calling medical flight services is valid.
Will Medical Flight Services Actually Save Time?
Air ambulance cannot land just about anywhere. They need adequate landing facilities and if such a facility is too far, it is futile to transport the patient there. You are better off transporting the facility to the appropriate nearest medical center through land transport. Also, there must be a reasonable time difference between the land and air ambulance transport to the destination.
Are the Weather Conditions Congenial for Medical Flight Services?
FAA is already trying its very best to raise the safety standards of medical flight services. Bad weather and poor visibility are risky by themselves. A land ambulance would be a much safer choice in circumstances like these.
There are a lot of technicalities involved with air ambulance services and it is not always the quickest option. So, discuss the mode of transport with the decision-making authority on the scene, although you don’t have the real authority for making the decision when you are dependent on insurance for cost coverage.
Speak of flights and the first thing that comes to mind is the price tag; however, one needs to look at medical flights from a totally different perspective. While price can be a criterion, it can never be the only one. Here are certain factors that you must be taking into consideration to ensure the wellness of your loved ones while choosing medical flights.
The type of medical flights being used
Not all medical flights have the capability of running in tough weather conditions. Plus, the air ambulance needs to be cabin pressurized for patient safety. There are aircrafts that are often used part-time as chartered planes; you are advised to steer away from such medical flights as the chances of them being fully equipped medical emergencies is questionable.
Medical flights and safety compliance
Look for the accreditations. A company that complies with the rules laid down by the Federal Aviation Administration is the best one to choose. Violation of these norms is usually recorded and made public so that people have the choice to avoid them.
Medical flights with qualified crew
This one might come as a shock to you but providers of medical flights are not mandated by the government to maintain standards when it comes to qualified staff (apart from the pilot). The doctors and emergency medical personnel might not have great credentials. Medical flights don’t come cheap and you deserve the best. Ensure that you are knowledgeable about the credentials and experience of the crew members.
Experience of the pilot
Medical flights take to skies in tough weather conditions some times. It is essential that an experienced pilot is in control of the aircraft. FAA mandates that the pilot has at least 1500 flying hours under the belt. Some providers have their own standards that are better than the FAA standards.
The medical equipments onboard
Medical flights are often required to take care of midair emergency situations. To accomplish this, they need to have adequate equipments like oxygen, heart monitors, etc.
The communication and coordination
Medical flights need to be in constant touch with the receiving hospital so that all necessary arrangements are made beforehand. Also, the medical flights need to have good communication systems that constantly keep the pilot abreast of weather conditions in the destination. Having adequate communication infrastructure saves crucial minutes when time is of essence.
Of course, people must ensure that their insurance policies cover medical flights so that they are not burdened by huge costs during emergencies that warrant air ambulances.
Megan Gilbreath was a resident of Abilene, Texas. She was an 18-year-old student who was involved in a motor vehicle accident involving her pickup. She had a rollover accident where she sustained a head injury and a broken leg. A medical flight was quick to respond and she was all set to be transported to the nearest medical facility.
However, one major error was committed. The EMT that belonged to the medical flight service had intubated her wrongly. The tube that was supposed to carry oxygen was inserted into the esophagus instead of her windpipe. As a result she was declared brain dead by the time the medical flight took her to the treating facility. All the while oxygen was being pumped to her stomach instead of her lungs.
Are You Safe on a Medical Flight with Mere FAA Regulations?
It must be noted that FAA is a regulating body for flights of all types and not just medical flights. This means the medical flight service providers don’t really have regulations that govern them when it comes to ensuring adequate medical care on the flight. FAA only has the say when it comes to medical flight safety when flying. It concerns itself with issues such as crew safety in bad weather conditions and medical flight during bad visibility at night.
Who Regulates the Medical Flight when it Comes to Standard of Care?
The Airline Deregulation Act of 1978 that paved way for using air ambulances during medical emergencies had one major flaw. It exempted the medical flight service providers when it came to “routes, prices, and services.” This loophole allows the medical flight service providers to have their own standards when it comes to services.
This however does not mean that all air ambulance service providers cut costs when it comes to standard of care. Most medical flight operators maintain high standards of medical care. However, in the highly competitive air ambulance sector, it is possible that there are medical flight service providers who cut corners through not-so-well trained or inadequately trained medical staff.
The Airline Deregulation Act of 1978 does have a provision where the states can regulate the medical aspect of air ambulances; the only condition is that such regulation should not impact the economics of operating a medical flight “significantly.” In essence, there is scope and hope for regulations in this regard.
Shauna Laswell recently suffered chest pains and was taken to a local hospital; however, she was diagnosed as having a heart attack. She had to be emergently flown via air ambulance to a Las Vegas hospital. Shauna did get great care and survived the medical emergency. When she received the bill, she was just short of having another heart attack – it was a whopping $38,800! Thanks to her insurance provider who did not cover the air ambulance cost, she got a reimbursement of only $6,200.
Why Was Shauna’s Air Ambulance Bill Not Covered?
Anyone would wonder why air ambulance bill was not covered, as heart attack is a life-threatening situation and definitely warrants an air ambulance flight. For one, the nearest medical facility was not the one she was taken to. Insurances only cover the distance to the appropriate nearest medical facilities. So, the vital question is, “What can I do to avoid a situation like this?”
Few Tips to Ensure Adequate Air Ambulance Insurance Coverage
Remember that only travel to the nearest medical facility is covered by insurance. Also, you are better off hiring the services of the air ambulance attached to the hospital, rather than hiring an independent medical flight service. The ones attached to the hospital are usually cheaper.
Look at the kind of coverage that your insurance provider provides. If there are clauses that keep you from getting full air ambulance cost coverage, steer away from such providers. Most air ambulance services have membership programs. Being a member of such a program gives you immunity against the amount not covered by insurance company. The air ambulance company itself would cover such amount.
Be prepared for eventualities. Air ambulances are being increasingly used these days. So, request for the air ambulance provider that you prefer. Know the air ambulance services that are affiliated with your insurance provider.
Most of the time, insurance companies do not cover 100% of the charges for air ambulance services. The Utah State Insurance Department has even issued a warning to the public in this regard.
The Federal Aviation Administration had laid down its groundbreaking safety rules for choppers in February of 2014, popularly known as the HAA (helicopter air ambulance) rule. It mandated that the choppers involved in emergency transport of the patient would have to meet requirements like:
- Inclusion of certain specific safety instruments
- Improved training and testing
- Establishment of control systems for air ambulance transport vehicles
These were only a few requirements that were laid down. Although the initial deadline to meet these requirements was April 22 of last year, it was then extended by a year owing to the difficulties of the air ambulance transport companies to comply with them at such short notice. Most air ambulance transport companies have already complied with the first set of rules, although there is some anxiety in the air ambulance transport industry as the deadline nears.
The Air Ambulance Transport Sector will have to Meet More Deadlines
Although the air ambulance transport companies will have to comply with several of the rules laid down this year, there are some for which the sector still has time. Here’s a breakdown.
Compliance by April 2016: Setting up of operations control center.
Compliance by April 2017:
- Installation of radio altimeters
- Incorporation of warning systems and terrain indicators for choppers
- Meeting qualification criteria for PIC instruments
Compliance by April 2018: Complying with mandated systems to monitor flight data.
Guidance is awaited by the Air Ambulance Transport Industry
The sources in the air ambulance transport industry revealed that it is not possible to comply with certain mandates unless there are clear guidelines by the FAA. Compliance with most of the rules will cost the air ambulance transport operators huge dollars, so obviously, they want to get it right and keep the expenses to a minimum.
For the pilots, crew and the people travelling in air ambulance transport vehicles, the rules will bring in more safety and efficiency. In general, the rules have been well accepted by the air ambulance transport industry so far.
Bed to bed air ambulance services are often used when the patient is critical or needs constant medical attention throughout the transport. Essentially, the air ambulance service would coordinate the services such that the patient is under medical supervision throughout the duration of the transport, including transfer from hospital to the air ambulance and air ambulance to the receiving hospital.
How is Bed to Bed Air Ambulance Service Beneficial?
For one, the patient is constantly under the observation of medical experts. The staff that accompanies the patient is usually provided by a separate agency other than the transferring hospital. The knowledge exchange between medical experts about the patient becomes easier when a bed to bed air ambulance service is used.
The air ambulance staff also makes arrangements for ground ambulance in case there is a need to transport the patient by land from the airport to the receiving hospital. At the same time, the air ambulance service would ensure that all vital arrangements in the ground ambulance are ready. This effort also reduces the transit time. Moreover, due to constant communication, the ground staff would be aware of the patient condition at all times.
The same goes with the receiving hospital too. In other words, the condition of the patient can be constantly communicated to the receiving hospital and all necessary arrangements can be made beforehand. Such an arrangement puts the worries of the patient’s loved ones to rest for the most part.
Is Bed to Bed Air Ambulance Service Expensive?
It is slightly more expensive when compared to ground ambulance transport and a normal air ambulance transport where the patient is brought to the medical flight independently.
The fact that there is a lot of coordination involved with bed to bed air ambulance service increases the price a bit. However, one must realize that the ground ambulance coverage and air ambulance coverage are calculated separately by insurance companies and if the doctor has recommended such close monitoring, the chances are that the entire cost will be borne by the insurance provider.
Availing bed to bed air ambulance service is not a call that you must take on your own. The decision must be left to the qualified medical professionals as it is only then that this service is approved by insurance providers.
If you are going on an extreme sports trip, the chances of needing medical care and air ambulance cover are naturally more. So, you need to question yourself, “Is mere travel insurance enough?” In fact, there are special travel insurance designed just for the purpose and you must look into them. However, before that, you must know certain facts.
Classifying Extreme Sports before Looking at Air Ambulance Cover
Going for a swim in calm waters or ruffling some waves by the beach does not count as extreme sports. Extreme sports are those where there is a high likelihood of mishaps, even after safety precautions, and can warrant emergency medical treatments including air ambulance evacuations. Some of these are:
- Deep sea scuba diving
- River rafting
- Rock climbing
- High altitude mountaineering
- Bungee jumping
- High-speed or cross-country biking
Air Ambulance Cover and Insurance are no Substitute for Reasonable Precautions
Most extreme sporting companies will not even entertain your request unless you have adequate extreme sports insurance. They might also demand that you have enough extreme sporting experience and practice behind you. The reason is simple; the eventualities in such sports can even mean death or disability. Having adequate insurance and air ambulance cover increases your chances of survival drastically. You are assured of immediate medical care in any foreign countries. One must note in this context that most countries outside the US demand assurance of payments before the treatment is initiated.
Choosing the Air Ambulance Cover and Insurance
Here are a few points that you need to consider:
- Your sports insurance might cover air ambulance evacuations. If that’s the case you don’t have to worry at all. However, it is vital to look whether there are limitations to this cover.
- Compare the costs. Sometimes buying a separate air ambulance cover is more economically viable. So check whether the travel insurance company is charging you exorbitant rates.
- Compare between various travel-insurance providers and compare the prices and the kind of facilities being provided. You would not only need air ambulance evacuation cover, but also coverage for medical consultation, hospitalization, and treatment.
- If you are going as a couple or a group, look for discounts. Never hesitate speaking to the company’s representative.
You need to fill your forms for extreme sports travel insurance clearly and mention the kind of activities that you would be involved in to avoid confusion later.
It is natural for one to wonder what separates medical flights from commercial charter flights, after all both would be available on demand. Of course, a medical flight would be fitted with equipment that are designed to serve the patients but one might ask whether such equipment can be made available at short notice in a charter flight. In fact some of the features of medical flights are always available in commercial charger flights. So, what exactly is the difference?
Oxygen System in Medical Flights
Oxygen would be available in both; however, medical flights store a different class of oxygen. Unlike charter planes that can only deliver about 4 to 8 liters of oxygen per minute, medical flights can deliver oxygen at 25 liters per minute. Plus it delivers medical grade oxygen and not oxygen butanes that commercial flights do.
Sickbeds in Medical Flights
The maximum you would find in a charter flight is a temporary stretcher. However, a medical sickbed is permanently anchored on medical flights and come with far superior features than a temporary stretcher.
Power Systems in Medical Flights
Medical equipment need power supply that is vastly different from that available on commercial charter flights. The equipment need DC 28V and AC 110V power supply, which is inbuilt in medical flights. No such facilities would be available in commercial flights.
Cabin Pressure in Medical Flights
Certain medical conditions demand that there is a constant barometric pressure. Medical flights are designed to maintain such pressures. On the other hand, the pressure in charter flights varies with altitudes over 5000 feet above sea level.
Medical flights are better equipped to handle emergencies
Medical flights only ferry passengers and would be on standby 24 hours a day. The patients are assured of qualified medical care onboard and do not have to make separate arrangements for that. Most life support equipment would be already onboard and only certain equipment in special circumstances need to be borrowed from the transferring hospital.
Every year over 400 thousand rescue operations take place employing air ambulance choppers and the numbers are only increasing. There also has been a surge of private players in the air ambulance industry, which has led to a whopping demand for air ambulance pilots. If you have a flare for flying and a heart to serve the needy, career as air ambulance pilot is right for you. Here, we discuss the path to become an air ambulance pilot.
Air ambulance companies demand that you have the requisite education
No company will employ you unless you have at least 2 years of college education, most prefer a 4-year degree. Veer towards subjects like aeronautical engineering and physics for your major.
US air ambulance companies will ask you for a second-class certificate
This is a medical certificate that clears you to train and fly as a commercial pilot. You can get this through an Aviation Medical Examiner. To find one, visit the FAA website.
Attend a flight school
Ensure that you attend one that has been certified by FAA. Alternatively, you can also train under an instructor who has been certified by FAA. People who have served in the military and have enough flight hours under their belt are exempted from this.
Instrument training to fly air ambulances
As a US air ambulance pilot, you might have to fly in tough weather conditions. This also involves flying using instruments when visibility is low. You will have to garner a total of 40 hours of instrument training.
Gain experience and flight hours
Most air ambulance companies will demand that you have a minimum of 1000 hours of flight experience. While training for these many hours can be expensive, an easier alternative is to join an aviation school as an instructor.
You are all set to apply to become an air ambulance pilot
You are now free to apply for an air ambulance job in the market. With so many US air ambulance companies already existing, you are sure to land a job pretty quickly.
If you felt the medical situation warranted the air ambulance trip, yet Medicare refused to cover the charges, you don’t necessarily have to be disheartened. You can still check a few things and appeal Medicare to cover the air ambulance expenses.
Check Your Paperwork and Medicare Summary Notice (MSN)
Medicare gives you the reason for not covering air ambulance trip and there can be two primary reasons for it:
- The air ambulance company failed to appropriately document your need for air ambulance transport: In a situation like this, contact the doctor or social worker who was involved in mandating the air ambulance transport. Send this information to the organization that handles your medical bills on behalf of Medicare.
- The air ambulance company failed to file appropriate paperwork: You can always ask your air ambulance company to re-file your claim. If this does not yield results, you can then proceed to file an appeal.
If Medicare Still Refuses to Pay, File an Appeal
People who have Medicare have certain rights and one such right is filing an appeal against non-coverage of your air ambulance bills. Here’s a stepwise approach:
Look at MSN and find reason for not covering the air ambulance trip: Apart from the reason, the MSN will also let you know the time by which you need to file the appeal.
- Follow the instructions on MSN to file the appeal against non-coverage of air ambulance trip: It will also contain the address to which you need to send the appeal. You must accompany it with a letter stating why your air ambulance trip must be covered.
- Get in touch with the doctor who suggested air ambulance services: Attach this information to the MSN before sending it to the designated address.
- Keep a copy for yourself: You might need the copy of your appeal as a proof, so make a copy and keep it with you.
You can also get in touch with Medicare at 1-800-MEDICARE or visit www.medicare.gov/appeals.