Does Your Insurance Cover an Air Ambulance?

What you need to know about air transfers

Air ambulance insurance coverage basics and examples
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Air ambulance coverage can come in handy if you're injured while you're traveling, or if you need care due to an emergency or a condition that requires specialized treatment that's not available at your local hospital or health-care center. Air transport may be used during an emergency or to obtain certain services.

This coverage may be included in health insurance or travel insurance. Look at your travel or healthcare plan in advance to choose the one that offers it with the lowest out-of-pocket costs and deductibles, as well as the co-insurance terms that work best for you.

What Is an Air Ambulance?

An air ambulance is also known as a medical air transport. It's any form of aircraft equipped with supplies, equipment, and qualified medical professionals that will provide mobile care during transport.

An air ambulance transports patients to facilities when other transportation won't provide them with the needed care enroute.

Air transport may be by helicopter or by airplane. Its mission is to ensure the best care during transport to a medical center that can best deal with your condition, injury, or illness. Air ambulances are used when timing is of the essence in helping you receive treatment.

Air transports are helpful when you're injured during a trip and would like to receive care near to your home, or if you must go to a distant facility for specialized treatment. They can be helpful if you have to be transported to a rehabilitation center for specialized care. They can get you help fast if being transported by ground is impossible or will provide a risk to your health.

The air ambulance may take you to the nearest facility, depending on your health coverage. Or it may take you all the way home if your contract provides for a higher level of coverage. This is where it becomes key to fully understand the coverage you've purchased. Think about the kinds of activities or places you will travel to.

How Much Does It Cost?

According to the Health Care Cost Institute, air transport costs increased by 144% for helicopters from 2008 through 2017, the time of the last comprehensive study. The average cost was $27,894 in 2017. Cost increased 166% for planes, to $41,674 in the same year.

When Is It Covered by Health or Travel Plans?

Air transport can be covered by health or travel plans when the doctor at an emergency recommends air transport due to the fact that it is medically necessary. It can also be covered if you receive a letter of medical necessity.

Definition of "Medically Necessary"

Medically necessary refers to the care needed to prevent, diagnose, or treat an illness, injury, condition, or disease by current standards. This type of health care can refer to either services or supplies.

An air ambulance may be covered by a travel or health insurance plan that covers this cost it's deemed to be medically necessary, and if there is no other way for you to receive care, diagnosis, or treatment.

When Is It Medically Necessary?

Air transport may be contacted to come to you fast if you've been in an accident, or if you may not survive a trip in a land ambulance. The air ambulance has medical professionals on board, along with a mini-hospital where they can begin treating you as you fly.

Who Would Need an Air Ambulance?

You may need air transport when other forms of transportation would be dangerous to your health, or would risk the success of a needed procedure. You may need one if you're bleeding beyond the control of regular services, or if you need oxygen, life support, or other aid during transportation.

Air transport is often used in cases involving stroke, heart attack, burn care, head or spinal cord injury, and transplant. It's also common when injury occurs in a remote place where regular transport isn't accessible, or when large distances must be traveled in a short time.

Is Approval Required?

Air transport must still be approved by your health or travel insurance, even if the doctor involved recommends one. A doctor working for your insurance company will review the request. They will decide if it is necessary by current standards. Your insurer must approve the recommendation or you may not be covered.

Does Insurance Always Cover the Cost?

Many people who have insurance through their employer, Medicaid or Medicare, or a private travel or health insurance plan don't think twice about an ambulance bill. They think the insurer pays for it. But you could still end up with a hefty bill even in cases where coverage is provided, given the clauses in health and travel plans such as deductibles and co-insurance.

Air ambulances are not automatically covered. They're subject to the rules of each insurer.

You should never assume the full costs of air transport will be covered. You may end up paying thousands of dollars out of pocket if you don't check with your insurer first. The costs of air transport stem from the company used, the services provided, and the travel distance.

What Are the Limitations and Exclusions?

Coverage for air transport will vary from state to state and by insurance type and company. You can contact your state insurance commissioner's office to find out more about the coverages available in your state if you're unsure.

Some companies cite when this coverage may be provided in whole or in part. Some will limit the type of aircraft that's covered. They may also decide to pay only the portion of the cost that they deem to be "reasonably necessary." The balance of the bill could be at your cost in these cases.

Beware "Out of Network"

Make sure your coverage will accept the air transport service you're using, even if air transport is covered. You may not be reimbursed for the charges if the air ambulance is "out of network," or you may only be paid up to a certain amount.

Ask your insurer about out of network air ambulances and what you should do if you need one. According to the National Association of Insurance Commissioners, this can cost you tens of thousands of dollars.

How to Make Sure You Have Coverage

Contact your insurer, employee benefits plan administrator, or your agent to see what air transport coverage you may have. Ask your insurer if you can add extra coverage for an air ambulance if you don't feel that you have enough.

You might also check to find out if you're covered under a spouse's health insurance plan, or under domestic partner benefits. You could look into reducing costs using coordination of benefits in cases like this. You may need to look into another insurance company if you still feel that you need more coverage.

For Emergencies Only?

According to the Association of Air Medical Services, more than 550,000 people use air transports per year in the U.S. It is not always for unplanned medical emergency services.

A service could be medically necessary but may not be urgent. Care may be required during transport, but the timing of the transport isn't critical. Hospitals often coordinate to transport patients. They can set a schedule to help lower the costs of the in this case.

Is It Covered by Medicare or ACA?

Medicare or Affordable Care Act (ACA) plans may pay for services like emergency air transport if no other form of transport is available, and if it meets the rules for being medically necessary. But this might be subject to a deductible and to the co-insurance clause of your plan, so you would still end up paying part of the costs out of pocket.

Advance Beneficiary Notice of Noncoverage (ABN)

You may receive an “Advance Beneficiary Notice of Noncoverage” (ABN) if air transport is deemed necessary but not urgent. The ABN will advise you before taking the service that you will have to pay for all charges.

Transport of a Companion, Dependent or Spouse

Insurers will often include coverage for a family member or companion if air transport is covered. Be sure to ask your insurance rep.

Is Air Ambulance Service a Good Idea?

There are many private air transport services available. They're often geared toward travelers who would like to be able to fly back to their home doctor or hospital to be treated if they happen to need care while they're away from home. 

These are great services, but they may not provide for all needs. Contact your insurer prior to making any commitment, or you may find that your claim isn't approved.

Private air ambulance providers often have an insurance coordination service, so be sure to find out if they can help you with your insurance and outline what costs will or will not be covered. The best thing to do is to make sure you ask plenty of questions. Read any contracts with care before committing.