Air ambulances offer rural residents iffy memberships

Rural residents rely disproportionately on air ambulances to reach distant medical care in emergencies, but many have been hit with huge, unexpected bills since many such services aren't in insurance networks. To combat fears about such bills, ambulance services have been increasingly advertising prepaid subscriptions that promise patients free use of their helicopters in an emergency. 

"Nationwide, though, state insurance leaders, politicians and even one of the nation's largest air ambulance companies have raised concerns about the slickly marketed membership campaigns," Sarah Tribble reports for NPR. "The memberships often don't include every ambulance company in an area, and the choice of which medevac service answers a call is out of a consumer's hands."

Meanwhile, the cost of air ambulance services has soared in recent years. The median price for an air ambulance trip increased from $22,100 in 2012 to $36,400 in 2017—a 65 percent jump. Medicare and Medicaid patients pay lower fees or even nothing for such trips, but those with private insurance often find their plans don't cover the entire cost of the service, leaving them saddled with "balance bills" for the uncovered portion, Tribble reports.

States can't regulate air ambulance rates, routes or services, but several, including North Dakota and Montana, have introduced or passed bills to limit air ambulance memberships or decrease the likelihood that subscribers would get stuck with balance bills, Tribble reports.

The federal government does have the power to regulate air travel, though; Congress formed a committee last year to look into air ambulance bills. Air ambulance lobbyists blamed inadequate Medicare and Medicaid reimbursement for the high rates and asked that the federal government reimburse them more, Harris Meyer reports for Modern Healthcare.