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.
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.
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.