The advancement in medical flight performance has a lot to do with the development in oxygen equipment in recent times. Typically, medical flights make use of portable oxygen equipment at altitudes less than 10 thousand feet above the sea level and fixed oxygen equipment if attitudes above 10 thousand feet are achieved by the air ambulance on a regular basis. Typically, the oxygen equipment consists of storage system, tubing, gauges, and mask. Traditionally, oxygen has been carried in gaseous form; however, the new advancements in technology have made way to solid stage oxygen which allows for carrying of greater quantities of oxygen.
Equipment Check Before the Medical Flight Takes Off
It must be ensured that all occupants of the medical flight are well aware of how to don and doff oxygen masks and fit the head harness properly. They should also be knowledgeable about checking the pressure gauges and indicators. Of course, it’s also necessary to check them for faults before the flight. The paramedics would do all these checks for the patients aboard the medical flight.
Each oxygen container is designed to withstand altitude up to a certain level. This must be taken into consideration before embarking on the medical journey. The expected duration of breathing and the duration of the flight are other aspects that must be considered.
Types of Oxygen Masks and Regulators
Continuous flow regulator ensures a 100% flow of oxygen. This usually contains a re-breather mask that allows the user to reuse some of the exhaled oxygen.
Demand and pressure demand works by providing oxygen to the user on demand. In other words, the oxygen only becomes available when the user is inhaling. Such oxygen usage is very stable and can be used up to 10 thousand feet above the sea level. This type of oxygen release becomes necessary in fixed wing aircraft where there travel long distances, often across continents.
‘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.
Not all medical travels warrant a medical flight. When time is in your hand but the treatment for the ailment demands that you travel long distances, medical flight stretchers can be quite useful and economical. The cost of this service would be a fraction of what an air ambulance would cost you. However, there are certain points that one must keep in mind before booking a medical stretcher and we discuss those in some detail here.
How Isolated is the Patient in the Medical Flight Stretcher?
Medical stretchers naturally occupy more space than a normal seat would. Plus there might be the need of space for some basic medical equipment. All this space translates into higher cost. The agency you have hired might cut corners by trying to make do with minimum space. It is wise to clarify this beforehand. Isolation from the rest of the fight is extremely necessary.
Does the Air Ambulance Company take Care of the Logistics?
You do not want to risk taking the patient in your car to the airport. It is always wise to have an ambulance for this purpose. Does the agency take care of this? Also, the on-boarding and off-boarding of the patient must be a quick process. The agency needs to anticipate all possible hurdles to this and take care of it well in advance.
Booking the Hospital Bed on Arrival in Advance
You do not want to run around to book a bed in the hospital of your desire. While you standby the loved one with health issues, the agency must take care of booking the hospital bed in advance. It is vital that you ask about this beforehand and take confirmation of the booking. Of course, the ambulance too must be ready in the airport upon arrival to save time and get through the process quickly.
Lastly, one must not hesitate to clarify any doubts that they may have, with the coordinator.
You cannot deny the fact that a medical flight landing near your home or workplace can generate some excitement. Naturally, the inquisitive you would want to know what is happening. We all know that medical flights can perform tracheotomy to minor amputations on the spot. As a responsible person, you might want to help the injured or even the crew. As such noble thoughts run through your mind, you might not realize that you are putting yourself at risk. You might wonder how that is possible. This risk is precisely what we discuss here.
Help the Medical Flight by Helping Yourself
It takes no rocket science to understand that a medical flight or any helicopter, for that matter, needs enough space to land. In your enthusiasm, do not block the landing space. Better still, ask the fellow onlookers to make way for the medical flight to land.
Medical flights exert quite some down-thrust which can simply throw around kids, small pets, and loosely held objects. Stay away from such objects or secure them, while also holding your pets and kids so that they are safe.
Protecting your eyes from the dust that might be roused by the medical flight is important. You do not want to end up being a medical emergency yourself and burden the air ambulance crew.
Offering Personal Help is a Strict No
It is highly unlikely that bystanders are asked for help during medical flight emergencies. Do not approach the crew with an offer to help. You might simply be obstructing their work. Think of it; the crew is usually comprised of experienced paramedics, nurses, doctors and pilots who know their job well. In the event that your help is required, rest assured, they will ask for it. Unless that happens, the best thing that you can do is keep yourself out of harm’s way.
When time is of essence, no other transport is as effective as a medical flight. That said, there are limitations to this mode of medical transport too. A lot of issues also stem up owing to the fact that medical flight services are a recent addition all over the world. While they have been prevalent since decades, the extent of prevalence has shot up drastically in recent times. Here, we list a few limitations that one must be aware of.
Medical Flight Services have Limited Hours of Operation
According to law, no pilot can work more than a 12-hour shift in a day, regardless of whether he or she flies or not. Of course, some of the pilot’s time goes into the routine upkeep of flight logs, etc. but this does not necessarily mean the professional is paid less, and having several pilots is not a feasible option for most medical flight operators.
Extreme Weather Conditions can be a Problem
Think of land ambulances, their operation remains almost unaffected in any weather condition, but medical flight services are no insulated from this. Even the slightest hint sometimes can prevent their take off. It’s important to note there that haste to save a patient’s life can endanger the lives of the crew members.
Medical Flight Landing and Take Off
It is stating the obvious but airplanes naturally need proper landing facilities. Helicopters, on the other hand, can do with less space but it becomes a problem when receiving hospitals do not have a helipad, especially in urban areas, where space is always an issue.
Highly Trained Professionals are a Must
There could be two problems here. The first is finding highly experienced professionals to become crew members; this can prove tedious. Second, experience comes at a price and can, in turn, shoot up the costs.
Injuries can occur without prior warning, anytime, anywhere. It is a real possibility that you may one day find yourself in a situation where you need to care for a critically injured person until a medical flight arrives. Know that you can make a difference and there is a lot you can do to help the injured. However, first things first; call the 911 before you even attempt anything. Faster the paramedics reach the better. If the accident site is in the middle of nowhere, make that know clearly to the responder. There is a good possibility that the paramedics themselves will arrive in a medical flight for quick evacuation.
Your Role in the Meantime
The fastest that a paramedic or emergency services can arrive is 6 to 9 minutes. While these initial minutes may sound like a small time, they can prove to be the difference between life and death. The first thing to check is whether the patient is breathing normally and whether there is a wound that is letting blood out rapidly. First clamp the blood using a piece of cloth as a tourniquet. Position the patient such that the blood flow is against gravity. Administer CPR if necessary. Observe yourself; feeling stressed and nauseous in such situations is normal. Try and clear your thoughts and focus on the critical victim.
Stay Safe till the Medical Flight or Other Form of Help Arrives
Bravado is bad, especially if you are stuck with the victim in a tough terrain. The best you can do is tell the 911 responder exactly what has happened and answer the questions clearly. Apart from that ensuring that the patient is conscious by talking to them, controlling bleeding, positioning the patient right and administering CPR if necessary is the only thing that you can do. Remember, there are laws to protect you like the Good Samaritan Act that keeps you shielded from any legal liabilities in situations like these, so never shy away from helping.
Booking a medical flight can seem like a daunting task, especially in light of the fact that you would be booking an entire airplane for yourself. However, it is entirely different from booking a charter plane. In most cases, all you need to do is make a call to set things up. Here, we bring you a rough step-wise guide. Although the process may vary slightly depending on the medical flight provider, it would broadly remain the same.
Begin with a Simple Call to the Medical Flight Provider
Better still, you can simply fill an online form requesting the provider to contact you. Remember, at this stage, you are merely asking for price quotes and evaluating the options before you. Do not commit to booking a medical flight at this point. Also, it is recommended that you call multiple medical flight providers before zeroing on one. Expect questions like your current location, destination, and the diagnosis of the patient. Most providers will get back to you within 30 minutes and give you a price quote.
Ask What the Cost Covers
Ideally, the costs should include ground transport from and to the hospital and airport, medical crew and aircraft charges, equipment fee, landing fee, and a few other miscellaneous fees that should not amount to a lot. If any of these are left out, proactively ask about them so that you get a clear idea of what you are getting into.
Confirmation and the Ensuing Process
Once you confirm that you want to take the medical flight services from a particular provider, you will be asked for personal details like name, date of birth, weight, etc. You will also be asked about the desired time and date of transportation. You will have to give your passport details if you are flying international. You will have to specify whether a person would be accompanying you and also the amount of luggage that you would be carrying.
A medical flight becomes a necessity when travelling long distances on commercial flights is impossible, owing to the level of care that the patient’s health demands. On the brighter side, it gives the family members enough time to prepare for one. There are several things that the medical flight service provider will help the family and the patient with. However, being knowledgeable about certain aspects of the travel makes it easier for the family. The family must be prepared with the history and physical as well as the discharge summary of the patient, along with copies of insurance cards. Government issued identification is also necessary.
Limitations while Availing a Medical Flight Service
The patient’s family must understand that the medical flight is designed for the patient and carries a huge amount of medical equipment. Unlike, a commercial flight, it is not exactly designed for normal commuters. So, the family members must consult with the medical flight provider as to the maximum luggage that can be carried. It is usually about a 21-inch roller bag that is allowed. Some air ambulances do not allow for family members to accompany the patient in the medical flight; however, most of them accommodate at least one family member. It all depends on the space available and the size of the air ambulance. A quick check with the flight coordinator is always a wise move.
Availing International Air Ambulance Services
It is a given that the family must ensure that the patient’s passport, visa, travel documents and insurance are in place. It is advisable to also carry electronic copies of all the documents for easy retrieval and backup. A detailed discussion regarding the receiving hospital and the logistics between the airport and the hospital is advised. While experienced medical flight coordinators cover such things, there is no harm in knowing the details.
The United States of America is among the most expensive countries when it comes to health care. Of course, the quality of health care and the due diligence conducted is exemplary. However, not many citizens are able to afford much-needed health care in the absence of proper insurance. Now, couple this with the cost of medical flight services during emergencies. All these factors put together can form the perfect recipe for an imminent bankruptcy or at least a financial disaster that might take a lifetime to recover from.
Several Medical Flight Services Offer Discounts
We have seen a lot of instances where medical flight providers are forthcoming with discounts when the insurance carriers refuse to cover the expenses. However, this is not always enough. The compounding medical bills along with the medical flight expense can be quite high. So, what is the solution? It does not seem that the state governments capping the air ambulance fee is not simply enough. The question arises: is there a better way to handle this situation? Well, there is and it could be a joint responsibility.
Charity Medical Flight Services Could be the Answer
The United Kingdom has long relied on charity for the medical flight services. It’s not that maintaining air ambulances is cheaper in that country. However, it is often seen that medical flight services are a community affair. One comes across several instances where people go to great length to raise money for medical flight charities. Even Prince William has been a part of a charity medical flight service before. One finds that victims of accidents, invariably after their recovery pay for the act of kindness through fund-raising efforts. The country sees lotteries that had held to raise money regularly. Most importantly, the citizens and non-profit organizations together have realized the importance of such services for the good of humankind.
More often than not, we hear about skyrocketing medical flight bills that families are forced to pay. While it is natural for such families to feel victimized, having some prior knowledge about insurance coverage can prove helpful. If you are among those people who feel all they need to do is pay health insurance premiums, sit back and relax, here’s some news: your most basic health needs might not be covered. This mostly happens when the medical service provider is out of network.
Out of Network Medical Flights can Be Expensive
Take the case of 8-year-old Ben Millheim who met with an unfortunate accident fracturing his skull. The injury necessitated using a medical flight service to a hospital about 100 miles from the site of injury. While the boy survived and recovered well, his parents are still reeling under the $32,000 medical flight bill. Unfortunately for them, the medical flight service that they had used was out of their insurance network. As a result they are now liable to pay the service provider the ‘balance bill.’ In other words, they have to now shell out of their pockets the amount that their insurance provider has refused to pay the medical flight company for the reason that it does not come in their network.
It’s Almost Always a No-win Situation for Patients
Life-threatening injuries leave little room for checking whether a particular medical flight service provider is covered by the health insurance. While insurance companies flatly refuse to bear such expenses, it has been seen that air ambulance companies usually offer a discount to such patients. Plus, several states in the United States have passed legislation to limit balance billing; however, some states like Missouri have not. It must also be noted that there is no federal regulation that governs balance billing, leaving people vulnerable.