There’s a lot happening in the air medical transport industry currently. With the state lawmakers and the feds trying hard to end surprise air medical billing practices, there is a high degree of lobbying that is taking place both by insurance and air medical transport industry. There is a huge amount of blame game going on. Both parties are trying to pin the blame on each other. Often, you’ll find articles that highlight high bills that patients are compelled to foot and on the other hand, articles that detail the plight of the air ambulance industry and the rising costs it is grappling with.
What is a Surprise Air Medical Transport Bill?
In order to understand what surprise air medical transport bill is, we should adopt an industry agnostic perspective. The problem is not just with the air ambulance industry, it is rampant throughout the medical world. In the United States, unlike other parts of the world, insurance is a matter of network coverage. If a provider is not covered by the insurance company, it is likely that the reimbursement is going to be rejected. This compels the patients to foot the bill all by themselves. This phenomenon, where a person is compelled to pay a medical bill, in spite of having medical insurance, is known as surprise bill. This is what the polity of the nation is currently trying to eliminate.
Why is Tough to Eliminate Surprise Billing?
There are several facets to this. Some air ambulance companies, in the absence of fair reimbursement by insurance industry, simply do not want to come in network. The question arises, “Why?” The answer is obvious – this move paves the way for balance billing where the patient becomes responsible to foot that cost which is not covered by the insurance provider. Then who is to blame? Well, both insurance and air ambulance industries: the insurance industry because it refuses to reimburse a fair amount and the air medical transport industry because it refuses to come within insurance networks. It’s a Catch-22 situation.
Travel insurance is the safety net that you need when travelling abroad, especially in countries where the quality of health care is not the same as the one you enjoy in your home country. In such situations, air ambulance can become an absolute necessity. Most people assume that travel insurances automatically ensure an air ambulance to their home countries if they felt there is a necessity and that it is the patients’ choice to get the treatment wherever they desire; however, these beliefs are far from true. The insurance company can actually deny a claim and for the patient to get treatment in the visiting country. The company would weigh the cost advantage in situations like these.
Checks Air Ambulance Cover Before Purchasing the Travel Insurance
Explore as many travel insurance options as you can before zeroing down on a specific one. Reveal upfront the kind of activities you plan to indulge in and check out the premiums. If you have any pre-existing illness, make that known clearly and check out the premiums. The fear of higher premiums must not deter you from making this revelation as you can get into a huge financial mess owing to this mistake later.
Know Your Coverage Well
Also, some activities are considered very high risk and certain travel insurance policies might not cover them. If you’re going to be a part of some extreme adventure event, check out the facilities that the organizers offer and also whether the insurance company is willing to cover the mishaps that occur during such activities.
There have been several instances in the recent past where the travelers have not bothered to look closely enough whether the insurance company covers air ambulance services and later have had to resort to crowd funding to afford international air ambulance services. A little homework can avoid such issues and make your travel more secure and safe.
‘Stringent’ is the word that comes to mind when you think of medical flight insurance coverage norms. Cost reimbursements of medical flights can mean between a retaining your life savings and letting it go to cover the huge bills. It is important to know the basis on which insurance companies accept or deny the claims. Of course, the foremost thing is to own a health insurance policy that covers medical flight services or medical transportation of any form for that matter. If this condition is taken care of, following are the other conditions that you must be mindful of.
Insurance Coverage for Medical Flight Services
Medical flight services to and from hospitals are covered by Medicare Part B. It is worthy to note here that air medical transportation to skilled nursing facilities is also covered under Part B. However, it should be noted that medical flight coverage is provided when it is deemed that ground ambulances are not suitable for the medical condition or when it is determined that the patient is in dire need of care and timely care is possible when the patient is carried to the treating facility in the shortest possible time via an air ambulance.
Approval by the Treating Professional is Necessary
The ultimate decision of whether a medical flight service is necessary lies with the treating professional who could be a physician or a paramedic attending an emergency. This decision cannot be taken by the patient and in most cases cannot be overruled either.
If the medical flight company feels that the patient might not be able to pay for its services, it can ask the patient to sign Advance Beneficiary Notice that states that the patient would be responsible for the payment in case the insurance company refuses reimbursement. The patient can refuse to sign this notice; however, if the air ambulance company goes ahead and carries the patient, he or she might still be held responsible for the payment.
Americans today seem to have a false sense of security thinking that everything related to their medical wellbeing is automatically covered by health insurance. The reality is far from this belief. The health insurance providers differentiate between hospital expenses and medical air transport. While a good insurance will cover almost the entire medical treatment bill, the same insurance would hardly cover one-third of the medical air transport bill. To make matters worse, the medical air transport cost, even for short distances, sometimes is very high.
Why are Medical Air Transport Costs so High?
Maintaining helicopters and airplanes is no child’s play. It’s an expensive affair. Plus, keeping emergency professionals on standby at all times means additional costs. All these expenses, of course, have to be ultimately borne by the patients availing the services or the health insurance providers. The insurance providers only cover the in-network medical air transport services, and since insurance companies tend to disagree with the high bills that air ambulance companies generate, they only end up covering a part of it. This dissuades these companies to go in-network with the insurance carriers.
There is a Way Out and It Does not Cost Much
All it takes is a bit of planning. When you know well that insurance companies do not cover the expenses fully, exploring other options is the wise thing to do. There are several agencies that specialize in providing medical transport coverage. The costs are nominal and the coverage is usually good. They cover those expenses which are left uncovered by the insurance companies. So, in today’s world while ensuring medical insurance coverage is important, it is equally important to also keep yourself and your family covered for medical air transport emergencies. Failing to do so, can land you in a financial mess that can take years to clean up.
While medical air transport is, no doubt, a life-saving necessity, the bills that the service generates can be quite shocking in most instances. The one belief that lands people in a financial mess is that having a medical insurance is enough to cover the medical air transport bill. Nothing could be far from reality. Insurance companies usually have a tie-up with only a few air ambulance companies. The rest of the companies are considered “out of network” by these insurance providers. What makes it worse is that medical emergencies do not always allow people to choose the in-network companies. When it’s a question of life and death, the quickest service is always the first priority.
Medical Air Transport Requirements are Real – Plan Them
“Prevention is better than cure” and this saying holds true for medical air transport planning. People need to get out of denial thinking, “Oh, that’s a farfetched requirement for me.” Memberships are offered by most air ambulance companies at a very reasonable price. Availing these is the wisest thing you can do.
What if You Do Not Have Air Ambulance Coverage or Membership?
Let’s consider a scenario where you end up with a huge medical air transport bill and you’re absolutely unable to pay it; plus your health insurance refuses to cover it. Get in touch with the air ambulance company, tell them your financial status and make it clear to them what you can pay. Most companies will agree to what you can pay (or at least a figure close to it). The reason is simple – a smaller payment is better than no payment at all.
You can request them for a payment plan, if you think you can pay it over a period of time. Also, negotiate with your health insurance company and try to get them to pay more. Do not shy away from taking legal opinion if it comes to that.
People fly across borders frequently for purposes ranging from recreation to business. One concern that bothers most of these travellers is reaching home safely in case there is a health eventuality. It must be noted that airambulance services can be quite expensive and cost more than $100,000 if you do not have adequate coverage. Yet, people tend to ignore medical flight cost coverage. This happens mainly due to misinformation. Here, we burst a few of such myths.
Airambulance Coverage Comes with Health Insurance Policy
This is the biggest myth that costs most people dearly. While some insurance companies cover a few air ambulance service providers, not all are covered. It is vital that you discuss the kind of coverage that your health insurance policy covers. Look at the coverage both domestically as well as internationally. Also, there is hardly any insurance policy that transfers patients to the hospital of their choice.
Travel Insurance and Air Ambulance Coverage are the Same
There can be nothing which is further from the truth. Travel insurance, unless specifically stated, does not cover air ambulance costs. You might be left to fend for yourself in foreign land where healthcare facilities are not up to your satisfaction. If your travel insurance brings you additional cover for medical flights, go for it. Otherwise, go for an additional cover through another agency.
Coverage for International Air Ambulance is Expensive
There is no truth in this statement. Coverage is often surprisingly cheap and does not cost more than $100-150. You can even get your entire family covered for an amount like that. Memberships are usually annual which means you’ll have to keep renewing it – a small price to pay if you fly frequently. Note that such coverage is available for both national and international travel.
Coverage through Credit Cards is Enough
Does your credit card take you to the nearest appropriate facility only or does it take you to the facility of your choice? Are you expected to make the arrangement for air ambulance? What distance is covered? These are just a few of the questions that you need to ask before solely relying on credit card air evacuation coverage.
If you have more questions regarding airambulance coverage, feel free to ask your questions in the comment section below. We’d love to allay your concerns.
Imagine being in a situation where your loved one has a serious health condition that necessitates use of an air ambulance service and you are left worrying about the cost of utilizing it. No one would want to be in a situation like this. But what if the air ambulance service that you choose offers to help you with the insurance? Yes, there are air ambulance companies out there that will aid you in getting adequate insurance reimbursements. They even hire qualified personnel for this specific purpose. These experts can even give you an idea whether your claim is likely to be accepted or rejected.
Medical Necessity for Air Ambulance Service
There is no denying that the medical necessity for using air ambulance service needs to be established first. How do you achieve that? Well, frankly speaking, it is not in your hands. The physician treating the patient will determine whether the patient needs air ambulance service or not.
If the treating physician deems the use of air ambulance service a medical necessity, will that mean you will get insurance cover? Well, not always. There is the medical director of the insurance company that comes into picture. It is in the right of the medical director to dispute the claims of medical necessity by the treating doctor. If he or she does so, the insurance cover may be denied. However, if you are in good hands, the air ambulance service may try to pursue the insurance reimbursement until the end.
What if the Efforts of the Air Ambulance Company Fail?
That’s a very unfortunate circumstance but not unheard of. If your insurance provider refuses payment and you do not have an air ambulance membership, you might be asked to pay the amount out of pocket. However, most air ambulance service providers offer discounts in such circumstances. You need to be ready to negotiate hard so that you end up paying the minimum.
The recent despicable act of terrorism in Paris recently has got the world together in solidarity with the French. However, it can’t be denied that there is an air of insecurity that is lingering in the air. The attacks have made air ambulance coverage all the more important in a new world where violence seems to make its way in ways that one can’t imagine.
It has been seen that there is a spike in demand for air ambulance coverage off late. So, the vital question is “what kind of air ambulance coverage do I need when travelling abroad?” Your visit could be for business or recreation, you need to clarify certain things with your insurance carrier and also look for additional coverage.
Does Your Travel Insurance Provide Air Ambulance Cover?
It is likely that it doesn’t. Most travel insurances do not cover air ambulance evacuations at all. You don’t want to be stuck in a foreign country in case you’re caught in an unfortunate incident, amid all the chaos. The first thing that would linger in your mind is being with your family and loved ones. So, specifically look for an insurance that brings you air ambulance evacuation.
You’re Better off with Additional Air Ambulance Coverage
There are specific air ambulance coverage plans available to you today. While the maximum that insurance can offer you is air ambulance transfer to the nearest facility in your home country or abroad, you can get a better deal than this through additional cover.
There are air ambulance plans today that promise to bring you back to a medical facility that is close to your home. Some even offer to transport you to a facility of your choice. If you’re thinking that the whole affair is going to be expensive, think again. There are plans that cover you both domestically and internationally for a few hundred dollars each year. All you need to do is look for a plan that suits you best.
You are just recovering from a serious health issue that demanded immediate attention. The matter was so urgent that it warranted an air ambulance transport. Just when you think that the worst is over, you are hit with a huge air ambulance transport bill. You breathe a sigh of relief knowing that you are covered by your insurance. Then, another shocker: the insurance company refuses to foot the entire cost. You suddenly find yourself spending sleepless nights not knowing how to foot such a huge air ambulance transport bill. Don’t worry, there’s still hope for you.
The Air Ambulance Transport Bill could be a “Sticker Shock”
It’s not unheard of in the healthcare industry where the listing prices are kept very high and air ambulance transport industry is no different. The prices are significantly lowered later, depending on the negotiating capacity of the patient. It is not unusual for air ambulance providers to come down to half the listed price. Some even offer flexible payment options.
Insurance companies that have huge number of subscribers are most likely to get huge discounts from air ambulance transport companies. Another factor is payment in cash. If you have the resources, the discount could be great. Also, you stand to gain if the air ambulance transport company is in the network of your insurance provider.
Community-Based Air Ambulance Transport Programs
Is the air ambulance transport company that you chose a part of community-based air ambulance transport program? If it is, then you’re lucky. The price is going to be low and is very likely to be covered by your insurance program. However, some air ambulance transport companies remain out of such community-based programs. These companies usually charge a huge amount which is not always covered by insurance companies. The amount not covered is usually recovered through the patient. If you have been served by one such air ambulance company, you might want to negotiate hard with the air ambulance transport company.
The different states of the United States are also in the process of designing a priority list which will mandate that health care providers give preference to community-based air ambulance transport companies before calling a provider who is out of such network.
Imagine being able to utilize air ambulance services, not just to the “nearest appropriate medical facility” but to a facility near your own home. Wouldn’t that be something that would make you really comfortable? Most insurance companies do not offer you such privileges but there is hope, especially when community members are able to come together to increase their bargaining capacity. When a community sits across the table to do business with air ambulance coverage providers, the sheer number of community members increases the bargaining capacity. For the service providers this translates into huge business and for you cheaper and more efficient air ambulance coverage.
Looking at Air Ambulance Industry Statistics
We have already mentioned earlier that more than 550,000 patients make use of air ambulance services each year in the United States. These patients have to shell out anywhere between $12,000 and $25,000 for their air ambulance transport (considering the national average of 52 miles per flight). If the requirement for air ambulance is to fly overseas the amount can go well into six figures.
We have already seen that most insurance companies shy away from covering the charges entirely. Also, most of them simply do not cover overseas air ambulance travel.
Air Ambulance Membership Programs and Community Associations
There are several air ambulance membership programs available throughout the United States today. These programs allow medical care seekers to fly via air ambulance services during emergencies to the hospital of their choice. The cost of such membership is not usually high. Also, if a community association ties up with such a service provider, the cost of membership goes down even further. In the wake of rising air ambulance costs throughout the country, such an arrangement is the best option to avoid getting tangled in high air ambulance costs.
It must also be noted that choosing or refusing air ambulance services is not in the hands of the patients during emergencies. It is a call taken by the medical professionals on the scene.