Recently a woman aboard a cruise ship called Norwegian Escape fell seriously ill. It went on to the extent that an air ambulance had to be called out. Lucky for her, the coast guard was reachable and quickly responded to the emergency by evacuating her. However, not all are as fortunate as this woman to find help when it is needed most while cruising through a fun vacation in high seas.
Often, while in international waters, with different national borders in place, the logistical problem can turn out to be a nightmare. The cost too can be quite high as evacuation is rather tough and involves huge distances. Insurance coverage is therefore of paramount importance.
Ask About Air Ambulance Coverage Beforehand
Not all travel insurance policies will cover air ambulance evacuation and you might have to shell out a huge amount for this purpose. There have been instances where people have even turned to crowd funding to pay air ambulance bills. The wisest thing, therefore, is to opt for a travel insurance that has comprehensive medical flight evacuation coverage. Moreover, you would not want to be treated in a foreign country if the treatment duration is long. Getting back to your home country among your loved ones would be among your top priorities.
Your Options without an Air Ambulance Coverage
If you have deep pockets, of course, there is absolutely nothing to worry but if you do not, it can be a problem. Minor ailments like broken bones, fever, and food poisoning is cared for onboard the cruise as each one hosts medical professionals. However, if the health condition is severe, the ship simply has to wait for the nearest port and admit you there. It would then leave with the remaining passengers once you are assured appropriate medical care. Sounds a little scary? That’s precisely the reason you need comprehensive air ambulance coverage.
The Right Questions to Ask a Medical Flight Company
Medical flights become a necessity when ground ambulances are not a choice. However, when the need for transport is not urgent, you have the time to make a sound choice, but first, you must know what questions you must pose to the medical flight company. Here, we discuss a few pertinent ones.
Does the Medical Flight Service Come Under My Insurance Network?
Health is important but cost is a factor too. Medical flight services can be quite expensive. When given a choice, you must exercise it to know what you are getting into. Air ambulance transport bills can run into the tens of thousands and in the hundreds of thousands, if the destination is across borders.
What Mode of Medical Flight is Right for Me?
Fixed-wing air ambulances are slightly more expensive than helicopters. However, they are quick and much more comfortable. In fact, preference must be given to fixed-wing flights if the journey is long. One major limitation, however, is its ability to land. Unlike helicopters, they need extended landing grounds.
Is the Air Ambulance Equipped Enough?
Today, one can hire air ambulances that suit the prevailing medical condition of a patient. For instance, you can hire one that is a flying neonatal care unit, if the patient is a newborn. Mission critical equipment like ECG monitors and the like must be available if the situation demands it.
Will the Organization Coordinate Care Beyond the Flight?
Most medical flight companies will offer you services that go beyond simply taking you from one place to another. They coordinate care with the receiving facility and keep in touch with ground ambulances if their services are required. If it is a cross-border transfer, the service provider may help you with the necessary formalities too.
These are some of the vital questions that one must ask before opting for a medical flight service to avoid any nasty surprises later.
Booking an international air ambulance sometimes becomes a necessity when you have to take your loved ones beyond the borders of the country you live in. In a country like the US or UK where the sector is heavily scrutinized and regulated, the chances of things going wrong is fairly small as long as you are financially sound enough to foot the bill. However, money is not the only criteria when you want to book an air ambulance in countries where regulations are slightly lax. In this context, one must understand that the industry is not that mature in most parts of the world, especially developing countries.
Fraud is a Possibility when You Book an Air Ambulance Across Borders
Take for instance, the case of an air ambulance company in the Indian capital of New Delhi. It is believed that an air ambulance company was booked by the authorities for purposely defrauding people after taking their money in advance and not offering medical flight services. The authorities only acted after the company had duped several people. One such person ended up losing his critically ill father owing to this fraud. He had paid the company in advance to transport his father from Johannesburg to India.
The Precautions One Must Take
- Accreditations are a good way to begin. Checkout whether the air ambulance company that you plan to hire is accredited by well known organizations. For instance, a company like REVA has multiple accreditations and is known to fly several patients internationally and has been doing so for quite some time.
- Another great way to check this out is by going through testimonials. Social medial channels like Facebook are a great start. See what other people are saying about the company to gain confidence.
- Referrals also matter. If you know someone who has used such a facility speak to them.
Finally, always keep in mind that internet should only be the first line of research. There is no substitute to speaking to air ambulance services first-hand.
Air ambulance operations are always critical. Among the critical operational aspects of a medical flight is handing off of the patient between medical flights and ground ambulances. If not done properly, it can lead to increased cost, loss of time and unnecessary lock down of valuable human resources. The efficiency at this juncture is all the more important because, usually, people from two different organizations have to come together to ensure a seamless transfer of the patient. In the event that each company has its own set of guidelines and procedures, things can get a bit complicated. It is for this reason that the Centers for Disease Control suggests a common methodology. Here we take a brief look at it.
The Planning of Hand Off between Ground and Air Ambulance
- Plan is the first thing that is to be put in place. It covers notifying each other of all developments. Beyond the ambulance companies, other organizations such as public health authority and law enforcement agency too might need to be notified.
- Communication of important aspects is another issue that must be taken care of – Does the patient have an infection? Is he or she ambulatory? Is there any special medical need? These are some of the questions, the answers to which both parties must have for communication to be effective.
- Location should be carefully chosen. It is not always about the nearest one. The patient may be a carrier of a highly infective virus. In a situation like this, the landing location should be such that the people in general can be easily isolated. The staff too must be aware that proper care should be taken to keep them from harm’s way. Adverse weather conditions are also important determinants of location. Media too can be an issue when it is a matter of national concern and can lead to a panic-like situation if information flow is not controlled.
There are several other aspects that must be taken care of. We will continue to focus on this subject in the coming days.
Air ambulance services play a critical part in providing medical care on time for stroke victims. The Centers for Disease Control estimates that about 795 thousand people suffer strokes every year in the United States of America. Up to 140 thousand of these people die of stroke. Approximately 610 thousand people have never experienced stroke before. To put these numbers into perspective, one person has a stroke every 40 seconds on average in the country. All these people need air ambulance services to receive care on time. If not, they are at risk of suffering disability for the rest of their life.
Air Ambulance Services are Time Critical in Stroke
It is said that the chances of survival and complete recovery improve drastically if the patient receives care within the first three hours of the stroke. Air ambulance services play a major role in ensuring that this. The fact that rural doctors are moving towards urban areas and the reality that rural hospitals are closing at a rapid rate makes air ambulance services for such regions critical and life-saving. These patients are in need of high-level care facilities equipped to handle this medical condition.
The Economics of Stroke
In the US, cost of stroke treatment is approximately USD 34 billion annually. This includes the cost of care, medicines and loss of work revenue due to medical absence. Despite this, insurances only cover about 30 to 40% of the cost related to air ambulance services. Why? Because the reimbursement rates have not been revised for over 20 years, which puts a lot of financial strain on air ambulance services. The result – medical flight service providers are closing at a rapid rate, especially in rural America. If something is not done about this by the congress, it could turn out to be a grave situation for the people in the near future.
Perhaps the biggest problem that people who avail medical air transportation services face is unexpected costs that run into thousands of dollars, even when they are covered by their health insurance policies. Now, a new bill has been passed by the state of Virginia that seeks to end this uncertainty. The bill is called ‘Air Medical Transportation; Informed Decision’. The bill was introduced by Jeremy S. McPike and it went into effect on March 1, 2019. It was passed by the House and Senate of Virginia with zero votes against it recently. Here, we discuss what this bill will mean for the common citizens.
What is Virginia Medical Air Transportation Bill All About?
The bill mandates that hospitals establish processes, which necessitate giving an electronic or written notice to the patients or their authorized representatives. The notice should contain the cost implications of availing medical air transportation services. It should also contain the alternative options including emergency ground ambulance options. If the medical air transportation is out of network of the patient’s health insurance, this fact too must be made apparent. Even if the medical air transportation is covered only in part, it has to be brought to the attention of the patient or his/her authorized representative.
What will the New Bill will do for the Patients?
Patients in Virginia will now have the power to choose whether they want to avail medical air transportation services. Further, it will let them know the cost implications beforehand so that they do not get any nasty surprises in the form of huge bills later on. It is a good attempt by the state to bring about transparency in billing.
It is hoped that the medical insurance companies and the medical air transportation industry will ultimately come to an understanding with regards to costs, facilitated by this bill.
The medical flight industry is highly competitive with hundreds of organizations offering this emergency service around the world. With insurance companies not always covering the full cost of the medical flights and people being wary of the high price involved, the question that is being contemplated is whether lowering the standards of service within the legal realm a viable option. Among the cost factors are maintenance, fuel, hangars, and staff. While the first three are almost impossible to control, staffing is something that most are looking at. Here are a few things that some medical flight providers around the world are considering according to a recent survey by ITIJ.
Cutting Down Medical Flight Staffing and Training Costs
Of course, the more experienced professionals such as doctors, nurses, paramedics and pilots come at a huge cost. But then, there are low-cost medical flight service providers who lower their standards when it comes to hiring standards. It must be noted in this regard that staffing is among the highest recurring expense for most companies.
Training can be expensive too. In order to maintain accreditations, constant training programs need to be held and medical flight companies must make way for the accreditation agencies to evaluate them. All these activities can push the costs high. Doing away with accreditations can cut the cost to some extent and this is among the reasons why several medical flight service providers veer away from them.
Containing the Cost of Equipment
The medical flight industry is constantly evolving, especially when it comes to technology. Using outdated equipment that is still legally acceptable is a choice that many air ambulance companies are contemplating today.
The question that one must ask in this context is whether this is the right path to take. People are entitled to best care possible at reasonable costs. How this can be achieved is a question that only future will tell.
The common assumption, most often, is that a patient is always flow to the nearest treating facility when an air ambulance is employed. However, this is not always true, although the nearest facility is taken into consideration owing to the cost as the nearest one would obviously cost the minimum. What people need to understand is that air ambulance is a live-saving service and not a cost-saving service. The primary criterion is therefore not just the nearest but also the most appropriate treating facility. For instance, a burn victim may be carried by the air ambulance to the nearest burn care center, although a highly specialized trauma care is just a few blocks away. Again, the primary intent here is to save lives.
Other Considerations taken Into Account by Air Ambulance
The paramedics have a huge say in deciding the treating facility. Of course, they cannot suggest any specific hospital as this would give a leeway for bias but they can specify the kind of facility that the patient should be flown to. Typically, the choice is between the following during medical emergencies:
- Trauma Centers
- Burn Centers
- Cardiac Care Centers
- Stroke Centers
- Pediatric Hospitals
What Happens When a Patient is Involved in a Multi-Casualty Incident?
Natural disasters, for instance, can result in multiple people in need of urgent care. In cases like these, it is impossible for one hospital to take care of all the incoming casualties, no matter how close it is to the incident. An air ambulance in such a situation will look for appropriate facilities, regardless of the distance.
Does Patient Choice Come into Picture?
There might be instances where your health insurance covers you in one particular hospital but not the other; it is fair to request the air ambulance service provider in such instances to fly you to the one that will not affect your coverage. However, one has to mindful whether the cost of air ambulance service, in such cases, is covered or not. It is wise to consult your case worker in a situation like this.
We have been citing the reluctance of insurance companies to revise their payment charts, in keeping with the time and also several air ambulance companies that simply refuse to budge down when it comes to the pricing.
This time around, Missouri Insurance Department has come up with a report that reveals, on an average, people of Missouri are paying about USD 20,000 for an air ambulance services. Of course, this is a whopping price for a common person, not just in the state but anywhere in the world. The report further said that close to USD 26 million was billed by air ambulance companies in the year 2017. Of this, 12.4 million is what people had to bear, taking into consideration deductibles and co-pays.
Does the Report Vilify Air Ambulance Companies?
This was a question that air ambulance industry advocates would raise without a doubt and not for any frivolous reasons. Balance Billing, which forces patients to pay the amount when insurance companies refuse to clear the air ambulance bills, had no mention in the report. The reason stated for this was ‘insufficient data’. One could even say that the lack of this data, sort of makes the report a little lopsided.
High Fixed Cost was Cited by Air Ambulance Companies
One aspect that should be appreciated about the air ambulance companies is that they have not shied away from saying the amounts charged to the patients are pretty steep. They have also expressed their helplessness in containing this, as the fixed costs of maintaining a medical flight is very high. However, what goes against the favor of some air ambulance companies is the fact that they are unwilling to come in the network of insurance providers.
As we have always stated, the air ambulance industry and the insurance industry need to come together to find a middle path, so that the common person does not have to bear the burden of huge bills.
It has almost become a norm to blame organizations that offer medical flight services but not many people take the time or the effort to understand why they charge so steeply. While it cannot be denied that there is a definite profit motive as these are commercially operated organizations, there is more to their expenses than what meets the eye. The costs are not simply limited to the fuel that is utilized, there are far wider factors in play that push the costs up and we explore some of these.
The Major Expenses that All Medical Flight Services Must Meet
Typically, an air ambulance does not undertake more than three missions in a day. For the rest of the time, this highly expensive machine is simply forced to sit idle. Moreover, it does not fly a single mission several days in a year. While this is a fact, the cost of the funds raised to acquire it continues to compound. Same is the case with the base; medical flight services need a place to park the choppers and fixed-wing aircrafts throughout the year and the rent is, obviously, an added cost that needs to be borne.
The Expenses of Maintaining a Highly Qualified Team
Highly experienced pilots, paramedics, nurses and the technicians are just some of the staff members that medical flight services need to hire. Then, there are support staff, operational staff and the management staff too.
Utmost care is taken to ensure that the crew is properly rested. This translates into stipulated work hours regardless of there being a call for medical flight services or not. Of course, many of the crew members also take care of other duties while the air ambulance is docked; nevertheless, it is an expensive affair. Constant upgrades and training are other sources of expense, not to forget the expenses of remaining compliant with ever-changing regulations.