Getting rushed to the hospital in an ambulance can literally be a life-saving measure. But it can also deliver a financial blow if you get hit with a huge bill because the ambulance service was out-of-network.
Unfortunately this happens more often than you’d think. Here’s what to know about ambulance bills your protections, and steps to take if you get stuck with a charge that seems outrageous.
Why Ambulance Bills Are Often Surprisingly High
- Ambulance services are expensive to operate – Available 24/7, skilled EMTs, expensive vehicles and equipment
- Fragmented ownership – Mix of municipal, private, non-profit, for-profit
- Limited insurance coverage – Low reimbursement so ambulances stay out of network
- Aggressive billing and collections
What does this mean for consumers? You can easily get stuck with a shockingly high out-of-network ambulance bill even when the rest of your hospital visit is covered.
A Real Life Example
Let me walk through what happened to me Last year, I ended up in the hospital with pneumonia and on a ventilator for 10 days. Thankfully I recovered
The total charges for my care were around $330,000 But I have decent insurance through work and after I paid my deductible, my insurer covered almost everything
I felt relieved until I got a bill for $3,000 for the ambulance transfer between hospitals while I was unconscious and critically ill.
My insurer had only paid $1,200 because the ambulance company didn’t have a contract with them. I was outraged to be stuck with the $1,800 balance when I had no control over what ambulance picked me up.
Why Ground Ambulances Are Not Protected by Law
This points to a huge loophole in the new federal No Surprises Act, which bans surprise medical bills in most cases except for ground ambulance services.
Lawmakers didn’t want to put more financial pressure on local ambulance services, many of which are struggling. Also, private equity firms now own some ambulance providers and aggressively go after patients for unpaid bills.
While not fair for consumers, banning ground ambulance surprise bills is complex. But it can deter people from calling 911 in an emergency, so we need a solution.
What You Can Do If You Get a Surprise Ambulance Bill
Here are some steps to take if you get a bill that seems really high:
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Negotiate the charges. Call the ambulance provider and say you can’t afford the bill. Ask for a discount or a reasonable payment plan.
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Dispute the charges with your insurer. File an appeal asking your insurer to cover more of the out-of-network cost. Cite financial hardship if necessary.
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Check your state protections. A handful of states like Colorado and New York have laws providing some balance billing protections for ground ambulances.
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Use relief funds if COVID-related. Hospitals can’t balance bill for COVID-19 care paid for by the CARES Act Provider Relief Fund.
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Consider an ambulance membership. Some ambulance companies offer annual memberships that cover your out-of-pocket costs if you need a ride.
My Steps to Get the Bill Reduced
It took me months to face my ambulance bill but when I did, I called my insurer and asked them to review the claim again.
The rep was very helpful – she reprocessed the claim right then while I was on hold and got the ambulance company to put a 30 day hold on collections.
In the end, my insurer paid an additional $1,500. I still owe $283 but that seems fair to me after all the care I received.
I hope sharing my story helps you be better prepared to deal with ambulance bills. It’s a problem that Congress really should fix to protect consumers from unfair charges in emergencies. But until then, be proactive if you get hit with a huge ambulance bill. There are ways to get it reduced or possibly even eliminated.
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To pay your ambulance bill, request a copy of your ambulance bill, or if you have questions regarding your ambulance bill, please contact our billing vendor at 800-906-6552.
Requests for Low Income Assistance
The Sacramento Metropolitan Fire District (District) does not deny necessary medical care or ambulance transportation to an individual based on lack of insurance or their inability to pay for services. Should you find yourself in a situation in which you cannot afford to pay your ambulance bill, please complete the Application for Low Income Assistance for Medical Billing, and email it to [email protected] along with all the necessary documentation.
If you are disputing the charges on your ambulance bill, please email us at [email protected].
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How To Not Pay Ambulance Bills? – CountyOffice.org
How do I pay my ambulance charges?
After Medicare or your insurance company has been billed, you can pay your portion of your ambulance charges here. We’ll just need some details from your invoice and your credit or debit card information. Not sure where your Ticket Number is? Have questions about how to submit payment?
Will you Bill my insurance for an ambulance?
We’ll bill your insurance and then collect your portion to make quick work of that ambulance bill. Let’s get it done right now! Do we have your Medicare or other insurance information?
How do you fight an ambulance claim if it’s not covered?
The good news is there are some ways to fight back. Consumer Reports suggests: Ask your insurer to review the claim. If it’s still not covered, contact the ambulance company and ask if the charge can be lowered or if the company offers a payment plan. “Talking to my insurer did the trick,” said Rosato.
What should I do if I have an out-of-network ambulance Bill?
And if you live in an area with several providers, make sure anyone who may be calling an ambulance for you knows about your membership. Negotiate the bill. If you get stuck with an out-of-network bill, ask your insurer to review the claim and cover more of the rest of the bill. If a phone call doesn’t resolve the issue, appeal.