Air ambulances are a boon when there is a medical emergency. Every minute counts during such times. And all you want at that moment is to save the life of your dear one- at any cost. There is no time to call your insurance agent then. Thus it is always good to do your research beforehand. So, does your insurance cover an air ambulance? And the answer is, mostly. Primarily your health or travel insurance covers these costs. But there is a lot you should know before you exercise this option.
What Is An Air Ambulance?
An air ambulance or medical air transport can be any form of aircraft like a helicopter or airplane equipped with the equipment, supplies, and medical professionals to give mobile care to the patient.
This whole package of facilities and aircraft ensures that the patient receives the best care en route and is at the required medical facility in no time. Air ambulances have saved millions of lives to date, and almost 550,000 patients use air ambulances every year. But despite the great help it is, it has a huge drawback- Its cost! Not everybody can afford it if an insurance policy isn’t already covering the expenses.
What Does An Air Ambulance Costs?
According to NAIC, an average air ambulance flight is 52 miles and costs between $12,000-$25,000. Though the final price will factor in the aircraft type, the air ambulance company, the distance covered, and services provided during transportation.
In some cases when distance covered has to from abroad to the US, the costs can reach six figures!
Thus, it is essential to know whether your insurance covers the airlifting costs. And if it does, how much?
Does Your Insurance Cover An Air Ambulance?
Do you know there is separate air ambulance insurance? But if you do not want to go for it, health and travel insurances too cover air ambulance costs. But there are a few conditions.
The doctor at the emergency must recommend air transport as ‘medically necessary.’ Another condition when your insurance will cover you is receiving a letter of ‘medical necessity.’
But What Is Medically Necessary?
Medically Necessary was defined by the American Medical Association in the “Model Managed Care Contract.” Based on this, the definition of ‘medically necessary’ in simple words is as follows:
How a prudent doctor gives health care and services to a patient to prevent, treat, or diagnose an injury, illness, disease, or its symptoms must be per the general standards of medical practice.
Also, the treatment’s frequency and extent should be according to the above treatment situations. Lastly, the treatment should not be for the economic benefit of any party. But only and purely for the medical fitness of the patient.
When Does ‘Medically Necessary’ Applies In Case Of Air Ambulances?
Some of the situations when an air ambulance can come to your rescue while complying with the Medically Necessary Clause are:
- You have had an accident or stroke, and you might not survive a transfer through a land ambulance.
- You are in a remote area, and land ambulances cannot reach you.
- The hospital reachable by land ambulance does not have enough facilities to treat you.
An air ambulance has a mini-hospital on board that can treat you on the fly. The doctor usually recommends an air ambulance if you need oxygen support, life support, bleeding uncontrollably, etc. It is most common in burn care, heart attack, transplant, head or spinal cord injury, etc.
In short, in emergencies, a land ambulance cannot cater to.
But so far, we know that you might get coverage if the attending doctor recommends an airlift. But is that all? Are no approvals required? Let’s see!
Does The Claim Need An Approval By The Insurance Company?
Well, here is where things get tricky. Though the attending doctor recommended the air ambulance, you still cannot avail of a claim until the insurance company doctor approves it as required by current medical guidelines and standards.
If the insurance company doctor does not approve the air ambulance requirement, you will not be covered.
But let us be positive that the insurance company doctor also approves your claim. But even though you will get most of the money, you must know about deductibles and co-pays. It is always good to enquire about them with your insurance agent when you take up the policy. Or you might still end up paying a lot of dollars from your pocket.
What Are Some Exclusions And Limitations?
Apart from deductibles and co-pays, there is more that you must know about air ambulance coverages. Some companies do not always pay you in full, but only the part they think is “reasonably necessary.”
Some such situations are:
- It would help if you used an air ambulance “in the network” of your insurance company. Otherwise, they may not cover the entire expense. You must also inquire what would happen if you have to use an ambulance that does not lie “in the network.”
- Sometimes air ambulance is not used for an ’emergency.’ It might be because extra care is required during transport. Be informed if such a transfer is covered and how much.
- Sometimes Medicare or ACA covers the cost of emergency air transport when no other option is available. Do check if this applies to you. But also enquire about the deductible and co-pays you are required to pay.
- ABN or Advance Beneficiary Notice Of Non-Coverage is a notice you receive before taking an air ambulance service that the reason is necessary but not urgent. And thus you will have to pay in full yourself.
- Check if your companion, dependant, or spouse is covered under the policy.
In A Nutshell…
Air ambulance is a useful service, but you should know your coverage before using this service. Many private air ambulance services provide insurance coordination services also. These companies help you claim your expenses, and some even follow up until the acceptance of your claim.
In short, ask questions and be aware of all the conditions before you sign up for any policy.
With this, we wrap up. We hope now you know everything about does your insurance cover an air ambulance. And if you having any suggestions or questions or doubts then please contact us via email. We are all ears and reply ASAP!