Air ambulances and Medicare

By Kay Kaylor
PREVIEW Columnist
For San Juan Basin Area Agency on Aging (SJBAAA), I am not only a part-time long-term care ombudsman, which is an advocate for residents at Pine Ridge, a 24-hour extended care home, and BeeHive, an assisted living residence. I also am an aging and disability resource specialist and trained Senior Medicare Patrol (SMP) and State Health Insurance Assistance Program (SHIP) counselor. Information on the many aging and care concerns will be included here.
Recently, air ambulance companies have been marketing in this area for memberships. Some of the information may be misleading, so read the fine print before you sign up. The state SMP contact, Greg Watson, sent some tips in answer to my questions, which clients have also asked.
First, Medicare pays for emergency transportation provided by the nearest appropriate facility, and Medicare payments to rural transportation services were increased through 2022. The transport must be medically necessary.
“Medicare may pay for emergency ambulance transportation in an airplane or helicopter if your health condition requires immediate and rapid ambulance transportation that ground transportation can’t provide and one of these applies,” Watson noted. “Your pickup location can’t be easily reached by ground transportation, or long distance or other obstacles, like heavy traffic, could stop you from getting care quickly if you traveled by ground ambulance.”
The air ambulance industry expanded by more than 100 bases nationwide from 2012 to 2017, according to a March report by the federal Government Accountability Office. The median price charged for a medevac helicopter transport was $36,400 in 2017 — a 60 percent increase from 2012. Medicare and Medicaid control the prices they pay, however, so enrollees have lower or no out-of-pocket expenses.
Air ambulance memberships are not insurance, so they can be canceled at any time by the provider without notifying the member. Also, the company that responds to a call may not be the one a person joined. Even if it is the same company, patients still must work with their medical insurance.
SJBAAA offers resources for people age 60 and older or on Medicare. For further information, please call me at 264-0501, ext. 1, or send an email to adrc@sjbaaa.org.

This story was posted on October 29, 2019.