I hope you can afford that air ambulance you need to save your life.

My first thought is by what reasoning is the insurance company not paying this? This kind of thing is the only reason I have health insurance. It doesn't make sense to pay someone else to pay for the routine visits and occasional bottle of pills which are the most I ever need and could easily pay for out of pocket. The only good... and of course essential reason to get health insurance is when it's suddenly a many thousands or tens of thousands of dollars bill they are supposed to pay for it- all of it! Over the deductible I had always assumed they were required to do so.

For those who don't know in the current state of health care if you don't get it via an employer and don't qualify for the low-income subsidies health insurance costs more than a house payment now and for that kind of money I definitely expect them to pay for things like this. I'm sure buried within the novel of legalese they send there are all sorts of gotchas. Maybe that's something that ought to be dealt with too.
 
cowman said:
My first thought is by what reasoning is the insurance company not paying this?
Click to expand...

The problem is that the medevac providers don't want to be 'in network' for any of the insurers. Even if insurance pays 6 or 8000 for a scene flight, the provider is not obligated to accept that as full payment. So far, most of them choose to squeeze the patient for whatever else they can get on top of the insurance money. With medevac being treated like an airline, entities like state insurance commissioners and and state DOTs have no tools to address this. As the insurers have no obligation to pay the full charges demanded by the providers, they just cut a check and wash their hands of the problem. As long as neither the providers nor the insurers have any pressure to negotiate fair in-network reimbursement, the system will remain as messed up as it is.
 
cowman said:
My first thought is by what reasoning is the insurance company not paying this?
Click to expand...

Because insurance companies are not in business to give money away. Insurance is a game.

Also policies are different. The person needs to check if air ambulance is included in their policy. When the medical emergency happens is the worst time to check the policy.

Insurance companies are not blind to the cost of medical transportation. And insurance companies are (slowly) investigating medical necessity. Is it medically necessary to fly a kid with a broken finger from the little league field to the hospital for a total of 8 minutes in the air? It happened here. Drive time? 12 minutes, and the ambulance was already on site when the injury happened so if time was of essence than the ground ambulance would have been at the hospital before the helicopter took off. Also being investigated is that when the same company owns the ground units as well as the air units, then that company gets to choose which unit to use. So usually the unit that brings in more money no matter how serious or not serious the patients condition is gets chosen. And as been mentioned before, there is nothing in place to determine how a patient is transported except the transportation company.

In my area there are Indian Reservations. The medevac companies know that Medicare will pay for a helicopter to fly out to the reservation to pick up a patient and take them to a place that can offer better care than the local clinic. And no one dares to tell the Indians no. But the medevac companies can charge Medicare anything they want, but Medicare will only pay what it wants to pay. And the Indians do not pay for healthcare. And if the paper work is not filled out properly, then that company might not get paid. Guess who then gets stuck with that bill. It ain't the taxpayer.

A person can certainly refuse to be flown by a medical aircraft. A person can shop around for the better company. Doctors don't call for medevac transport, they make the decision that the patient needs a place where better care can be provided. Then someone from the hospital makes that phone call. And usually they use what is most available and or convenient. And a person can haggle the cost with a medevac company. It is all part of the game.
 
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Ambulance rides are hard to refuse. I almost had to hit the guy in the face to NOT load me kin his ambulance. He cared about one thing only.HIS fare.
 
You guys are letting the hospitals off the hook - also the vast quagmire of middle-men between the patient and the pharmaceutical companies. 99% of us will never see the inside of a medevac helicopter. But most of us ewill be hospitalized and/or ground transported.
 
paflyer said:
I nothing else, I now know what biz James is in.

The issue is the opacity of the costs and pricing in the medical industry. I can't think of any other business where the price is not disclosed before service is rendered, or where the people in the business can deliver services based on their "orders" without the full knowledge of the customer as to what the cost to them will be.
Click to expand...

Car service, but the bill is usually much smaller.

I wonder at the ability to actually hold someone responsible for a bill if they aren't conscious to consent to it.
 
paflyer said:
I nothing else, I now know what biz James is in.

The issue is the opacity of the costs and pricing in the medical industry. I can't think of any other business where the price is not disclosed before service is rendered, or where the people in the business can deliver services based on their "orders" without the full knowledge of the customer as to what the cost to them will be.
Click to expand...

This has been my complaint for years. Try finding out what the itemized cost for a procedure will be at a hospital, assuming no complications. It's doubtful that anyone will even know, much less be willing to answer. And then there's the bill-padding, the unnecessary tests, and the ridiculous markups on everything from Tylenol to toilet paper. Hospitals are almost as big a racket as the undergraduate education system. Both industries deserve RICO indictments, in my my opinion.

As for air ambulance services, in addition to up-front pricing, I think what's needed is a plan that covers the services of any air ambulance company, secondary to whatever one's health insurance insurance pays. I researched this years ago and it seemed that every company had its own "membership," which is fine if you stay in one place all the time, know which provider(s) service that area, are conscious and able to specify the provider you're a "member" of if the need arises, and that provider is able to take the call.

And that's assuming that the hospital doesn't have some sort of kickback arrangement with one particular air ambulance company that trumps everything else. Having worked (ground) EMS and knowing about the bribery that goes on in the other direction -- hospitals holding "appreciation days" and giving away all kind of EMS swag for crews that consistently chose their hospital over the others when we had discretion -- no degree of corruption perpetrated by a hospital would surprise me. "Non-profit" my ass. They're all racketeers.

With every company having its own "membership," unless you belong to all of them, the best you can do is hope that the company you belong to is the one that responds. Otherwise, you're up ****'s creek, without a paddle, in a boat with a hole. That's why a national, any-company coverage option would be nice. But the last time I checked, there was no single plan that every company would accept.

Rich
 
Velocity173 said:
On a flight right now. 26 minutes from patient pickup to landing. Over an hour and a half if gone by ground. In rural areas, we blow ground out of the water every time.
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When I retired having well trained EMS and hospitals within 15 minutes was a consideration for the location of my retirement. When I go scuba diving I purchase insurance for emergency medivac..
 
We have policy's with two medevac outfits. Each is about $125/yr for the family, Guardian Flight and Life Med. I sure hope I never have to use it. If we ever have to use it I sure hope there are not a lot of strings attached.
 
Clip4 said:
When I retired having well trained EMS and hospitals within 15 minutes was a consideration for the location of my retirement. When I go scuba diving I purchase insurance for emergency medivac..
Click to expand...

If it’s a decent sized city, you’re fine. It'll have either a level 1 trauma center or a level 2 that also specializes in strokes & heart attack. There’s little need for air transport in that case. We almost never go into the city for a trauma pickup because ground transport will beat our times.

For me, I’ll be retiring in a remote area or a small town so I’ll definitely be buying a membership program, possibly two.
 
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Velocity173 said:
The vast majority of our flights aren't minor injuries anyway.
Click to expand...

Good to hear. Here in the southwest we have been used for a taxi service. I have seen the "patient" walk out of the hospital before the med team does. And Medicare foots the bill.

I flew a guy off reservation with a dislocated finger. I wanted to take it and yank it in place. He was self medicated for pain.... But it was reservation.....

Helicopters are made for that short distance flight from the accident site to the hospital. Kind of hard for me to land a fixed wing at the accident site on a rural road right outside of town, or the interstate that traffic is backed up for miles because of the accident. That is what the helo is made for and excels at. Problem is here where I am at is there is a company that uses helicopters for 250 mile cross country transports. Often at night and sometimes in weather while navigating around higher terrain. Well, after navigating weather and terrain it is longer than 250 miles. No time saving there, except the doctor gets to see the helicopter take off. All I can think is that the company is just trying to increase profits. Actually I know they are, I used to fly for that company.

I have no problem with helicopters when they are used for what they are designed for. Well I take that back, I do have one small problem with helicopters. I am terrified to get in one....:lol::lol:
 
Zeldman said:
Good to hear. Here in the southwest we have been used for a taxi service. I have seen the "patient" walk out of the hospital before the med team does. And Medicare foots the bill.

I flew a guy off reservation with a dislocated finger. I wanted to take it and yank it in place. He was self medicated for pain.... But it was reservation.....

Helicopters are made for that short distance flight from the accident site to the hospital. Kind of hard for me to land a fixed wing at the accident site on a rural road right outside of town, or the interstate that traffic is backed up for miles because of the accident. That is what the helo is made for and excels at. Problem is here where I am at is there is a company that uses helicopters for 250 mile cross country transports. Often at night and sometimes in weather while navigating around higher terrain. Well, after navigating weather and terrain it is longer than 250 miles. No time saving there, except the doctor gets to see the helicopter take off. All I can think is that the company is just trying to increase profits. Actually I know they are, I used to fly for that company.

I have no problem with helicopters when they are used for what they are designed for. Well I take that back, I do have one small problem with helicopters. I am terrified to get in one....:lol::lol:
Click to expand...

Never flown anything like a dislocated finger. Broken bones that require surgery, yep. One of the biggest problems isn’t even mentioned in the article, is the lack of care from rural hospitals. If they would actually treat patients instead of constantly transferring them to higher care, air ambulance wouldn’t get called nearly as much. Take something as seemingly simple as a venomous snake bite. Good luck finding a mom and pop small town hospital that carries CroFab (expensive). Then, you’ve got rural hospitals closing left and right just like the one in my county. With limited ground ambulances, they’re forced to call for air ambulance.

Old friend of mine flys an Agusta 119 in NM. 160 KTAS. Only helicopter I’ve flown that’ll go through VNE (152 kts) in level flight. For that aircraft, 250 miles would definitely be doable.
 
Only medevac story I have:

I worked with a guy that went turkey hunting with his brother. What they didn't know is that the landowner had given permission to another group to hunt the same land at the same time. Neither group knew the other was there.

He was calling a turkey. Later, he wasn't sure if it was a turkey or one of the other guys. What he did remember was turning his head, then getting shot. Left side of his head, neck, shoulder, and chest.

He said he remembered being loaded into the helicopter. He remembered the medic counting, "..., 14, 15, 16, ..." and figured out it was the pellet holes being counted. He said he remembered seeing the color of his blood and, having shot enough deer, knowing it meant he'd been shot in a lung. He said he remembered thinking about his 2 week old daughter and how he wished he had more time with her. Then he said that helicopter ride saved his life.

They do serve a purpose.

edit:

I can't remember how long he was out from work. He did lose the sight in one eye, and he liked showing off the pellets that were still embedded in his skin.
 
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Velocity173 said:
If it’s a decent sized city, you’re fine. It'll have either a level 1 trauma center or a level 2 that also specializes in strokes & heart attack. There’s little need for air transport in that case. We almost never go into the city for a trauma pickup because ground transport will beat our times.

For me, I’ll be retiring in a remote area or a small town so I’ll definitely be buying a membership program, possibly two.
Click to expand...

And driving 30 minutes for milk sucks too.
 
Clip4 said:
And driving 30 minutes for milk sucks too.
Click to expand...

Good thing I’m lactose intolerant. :) Well, as much as I like the thought of roughing it in the middle of nowhere, I probably will stick with small town life. We just got a new movie theater that opened this weekend!
 
RJM62 said:
And that's assuming that the hospital doesn't have some sort of kickback arrangement with one particular air ambulance company that trumps everything else. Having worked (ground) EMS and knowing about the bribery that goes on in the other direction -- hospitals holding "appreciation days" and giving away all kind of EMS swag for crews that consistently chose their hospital over the others when we had discretion -- no degree of corruption perpetrated by a hospital would surprise me. "Non-profit" my ass. They're all racketeers.
Click to expand...

I never thought giving away cheap made in china mousepads as a bribe lol

From my experience they often call the program that they know will be the least amount of trouble for getting the pt the hell out of dodge.

When your program gets to be known as one stop shopping and that your crew can probably handle things better than most small town docs, your in service time is excellent and your weather capabilities are the best you can get for a medevac, you really only are giving out swag so people have your number handy.
 
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Now that everyone has expressed their outrage, I suggest you buy a membership in a flight organization like I did. This is insurance, and it's ridiculously cheap.

My wife and I are covered for four years, and it cost $145. CareFlite covers North Texas and Southern Oklahoma, providing HEMS, ambulance, and fixed wing services.

AirMed covers 38 States and costs $85 per person annually.
 
3393RP said:
Now that everyone has expressed their outrage, I suggest you buy a membership in a flight organization like I did. This is insurance, and it's ridiculously cheap.

My wife and I are covered for four years, and it cost $145. CareFlite covers North Texas and Southern Oklahoma, providing HEMS, ambulance, and fixed wing services.

AirMed covers 38 States and costs $85 per person annually.
Click to expand...

So I am incapcitated, who is going to bother making certain AirMed comes to get me?
 
I really don't give a ****. It's your problem.

Jesus I get tired of the whining and complaining here.
 
Clip4 said:
So I am incapcitated, who is going to bother making certain AirMed comes to get me?
Click to expand...

Just find out who covers your area and buy their membership. In most cases, you can get by with only one membership for around $60 per year for your whole family. My county is shared by 2 providers, so I’d have to buy 2 memberships to ensue I’m covered. Some counties like where my parents live are paid for by the county.

In short, don't get slapped with hefty bills like in the article and plan ahead. Or get good insurance.
 
paflyer said:
I can't think of any other business where the price is not disclosed before service is rendered, or where the people in the business can deliver services based on their "orders" without the full knowledge of the customer as to what the cost to them will be.
Click to expand...

Never been to a Signature or other FBO where they refuse to disclose their fees ahead of time?
 
Velocity173 said:
Just find out who covers your area and buy their membership. In most cases, you can get by with only one membership for around $60 per year for your whole family. My county is shared by 2 providers, so I’d have to buy 2 memberships to ensue I’m covered. Some counties like where my parents live are paid for by the county.

In short, don't get slapped with hefty bills like in the article and plan ahead. Or get good insurance.
Click to expand...

First, the insurance you mention is not available in my area. One local trauma hospital has a the only air ambulance service and you cannot purchase prepay thru them. Second, the chances that I would ever need to be transported by air ambulance where I live is less than be struck by lighting twice in one day. I worked 30 years as an LEO and can only remember clearing an LZ 3 times for an air ambulance. 3rd, if I were to need an air ambulance, chances are it would be in an area not served by the local provider.

I am not against having insurance and buy insurance covering the best air anbulace service I can buy for scuba trips. Not that I am worried about the bill, but worried that with out a guarantor they won’t transport you in many other countries.
 
How on Earth does someone in bad enough shape to need helicopter medivac in good enough shape to consent to the ride? If there's no consent, how can someone bill them? Yes services were rendered, but they were never requested. That's like someone coming to your house and reproofing it without asking you, and then seeing you a bill for service.
 
Clip4 said:
First, the insurance you mention is not available in my area. One local trauma hospital has a the only air ambulance service and you cannot purchase prepay thru them. Second, the chances that I would ever need to be transported by air ambulance where I live is less than be struck by lighting twice in one day. I worked 30 years as an LEO and can only remember clearing an LZ 3 times for an air ambulance. 3rd, if I were to need an air ambulance, chances are it would be in an area not served by the local provider.

I am not against having insurance and buy insurance covering the best air anbulace service I can buy for scuba trips. Not that I am worried about the bill, but worried that with out a guarantor they won’t transport you in many other countries.
Click to expand...

In your case, like I said, you better have good insurance. Point is, the person you were replying to has got themselves covered, which is the case for the MAJORITY of the country. Just the two largest flight programs alone cover 2/3 of the country.
 
My helicopter ride after my skydiving accident was $12000. I received a bill for around $7000. I called them and asked about their payment plan and they said they didnt have one. I told them 'well good luck, cuz I dont have $7000 in a pile to give you. They asked what I could pay in a lump sum. I settled for $1200.
 
steingar said:
How on Earth does someone in bad enough shape to need helicopter medivac in good enough shape to consent to the ride? If there's no consent, how can someone bill them? Yes services were rendered, but they were never requested. That's like someone coming to your house and reproofing it without asking you, and then seeing you a bill for service.
Click to expand...

The entire hospital industry and any of its allied industries are like that. In emergencies, they rely on the legal doctrine of "implied consent," which boils down to an assumption that most people who are not in a condition to provide express consent would consent to be treated if they were able to do so.

The problem is that even when the patient is able to consent, hospitals and their allied industries almost never will provide prices for the services they propose to perform; and even in the rare cases that they do, they invariably leave out all the padding they add to the procedure for useless tests, the "consult fees" for every hospital employee who asks "How are you doing?" as they walk by, and the insane markups they apply to every single consumable product they use.

Sometimes they even bill you for products that they merely have ready to use, even if they don't actually use them. Drugs and other products that can't be returned to stock after they're opened or unsealed for use are billable to the patient, even if they're not actually used. I learned this when a local hospital told me I'd have to pay $900.00 for an $18.00 vial of Propofol for my unsedated colonoscopy, just in case they decided I needed it at some point. I decided to have the procedure done elsewhere.

It's a racket, pure and simple. Even the Mafia envies what hospitals get away with, all perfectly legally, every single day.

Rich
 
1. I get that the invoices are going to be high. The machinery isn't cheap. The cost of having pilots and medical staff ready 24/7 isn't cheap.

2. $45K is absurd though. But like someone else said, everything in the health care industry is absurd. Count me as one of the people who spent less than five minutes with the doctor and ended up with almost $4K in medical billing.

3. Like Rich said, it's one of the only industries where you can't get prices up front. When my arm was injured a few years ago I asked as I was leaving what I'd owe. The clerk said there was no way to tell me until they did all their stuff behind the scenes, and that would take a couple of weeks. <= = = people can say we shouldn't get the gov't involved, but that should be illegal as hell. And charging people more if they pay personally instead of having their insurer pay should also not be legal.

4. I get flamed every time I say this, but healthcare is the ONE industry where prices should be fixed.
 
Gerhardt said:
1. I get that the invoices are going to be high. The machinery isn't cheap. The cost of having pilots and medical staff ready 24/7 isn't cheap.

2. $45K is absurd though. But like someone else said, everything in the health care industry is absurd. Count me as one of the people who spent less than five minutes with the doctor and ended up with almost $4K in medical billing.

3. Like Rich said, it's one of the only industries where you can't get prices up front. When my arm was injured a few years ago I asked as I was leaving what I'd owe. The clerk said there was no way to tell me until they did all their stuff behind the scenes, and that would take a couple of weeks. <= = = people can say we shouldn't get the gov't involved, but that should be illegal as hell. And charging people more if they pay personally instead of having their insurer pay should also not be legal.

4. I get flamed every time I say this, but healthcare is the ONE industry where prices should be fixed.
Click to expand...

I'd settle for disclosed. Every hospital should have to post the average total costs for the hundred or so most-common procedures, along with their outcome statistics.

Rich
 
EdFred said:
Never been to a Signature or other FBO where they refuse to disclose their fees ahead of time?
Click to expand...

Heck no. If they won't tell me the prices up front, I'm not going

Automobile services is estimated work too, but their prices tend not to vary quite so much.
 
RJM62 said:
.....
As for air ambulance services, in addition to up-front pricing, I think what's needed is a plan that covers the services of any air ambulance company, secondary to whatever one's health insurance insurance pays. I researched this years ago and it seemed that every company had its own "membership," which is fine if you stay in one place all the time, know which provider(s) service that area, are conscious and able to specify the provider you're a "member" of if the need arises, and that provider is able to take the call.

Rich
Click to expand...


Here in the Great Pacific NorthWet, there are a couple medevac companies that offer membership. I have one with LifeFlight. Covers me in WA, OR, northern CA, ID and western MT, even if they aren't the ones collecting me. That covers me (and the spouse) for where we spend 95% of our time. We also have a membership with MedJet Assist. Its not initial scene to hospital coverage, but if I crash a bike in Thailand, they'll medevac get me home. And they'll front up to 60K to cover expenses. Luckily, my insurance company will reimburse me for whatever their coverage would have been had this happened here.
 
Velocity173 said:
In your case, like I said, you better have good insurance. Point is, the person you were replying to has got themselves covered, which is the case for the MAJORITY of the country. Just the two largest flight programs alone cover 2/3 of the country.
Click to expand...


How much would like wager the majority of the country has not purchased this type of coverage?
 
cowman said:
My first thought is by what reasoning is the insurance company not paying this? This kind of thing is the only reason I have health insurance. It doesn't make sense to pay someone else to pay for the routine visits and occasional bottle of pills which are the most I ever need and could easily pay for out of pocket. The only good... and of course essential reason to get health insurance is when it's suddenly a many thousands or tens of thousands of dollars bill they are supposed to pay for it- all of it! Over the deductible I had always assumed they were required to do so.

For those who don't know in the current state of health care if you don't get it via an employer and don't qualify for the low-income subsidies health insurance costs more than a house payment now and for that kind of money I definitely expect them to pay for things like this. I'm sure buried within the novel of legalese they send there are all sorts of gotchas. Maybe that's something that ought to be dealt with too.
Click to expand...

It's not insurance. Let's call it what it is: a service contract. Nothing more, nothing less. It's only insurance if it doesn't cover routine care but only covers extraordinary events. But that's not the way it works, and both the Feds and many states have mandated that certain routine care be included.

RJM62 said:
The entire hospital industry and any of its allied industries are like that. In emergencies, they rely on the legal doctrine of "implied consent," which boils down to an assumption that most people who are not in a condition to provide express consent would consent to be treated if they were able to do so.

The problem is that even when the patient is able to consent, hospitals and their allied industries almost never will provide prices for the services they propose to perform; and even in the rare cases that they do, they invariably leave out all the padding they add to the procedure for useless tests, the "consult fees" for every hospital employee who asks "How are you doing?" as they walk by, and the insane markups they apply to every single consumable product they use.

Sometimes they even bill you for products that they merely have ready to use, even if they don't actually use them. Drugs and other products that can't be returned to stock after they're opened or unsealed for use are billable to the patient, even if they're not actually used. I learned this when a local hospital told me I'd have to pay $900.00 for an $18.00 vial of Propofol for my unsedated colonoscopy, just in case they decided I needed it at some point. I decided to have the procedure done elsewhere.

It's a racket, pure and simple. Even the Mafia envies what hospitals get away with, all perfectly legally, every single day.

Rich
Click to expand...

I was trying to compare 2 employer-sponsored plans to another outside plan. I asked the employer provider to give me the pricing on certain drugs. They refused, saying I could only get the pricing info after I signed up and was accepted in the plan.

RJM62 said:
I'd settle for disclosed. Every hospital should have to post the average total costs for the hundred or so most-common procedures, along with their outcome statistics.

Rich
Click to expand...

The issue here is that most hospital/insurance contracts contain a MFN (most favored nation) clause. And non-disclosure requirements. Yes, it ought to be illegal. But it's perfectly legal.

As a side note, the reason that medical practices in some areas are being bought by hospital groups is that the way contracts (and gov't regs) work they can get a higher reimbursement for services provided by hospital-owned physicians.

As for insurers requiring "medical need", Anthem has started denying ER payments when they judge, after the fact, that the ER visit was not a true emergency:https://www.vox.com/policy-and-poli...emergency-room-coverage-denials-inappropriate
 
bflynn said:
Heck no. If they won't tell me the prices up front, I'm not going

Automobile services is estimated work too, but their prices tend not to vary quite so much.
Click to expand...

Lol

Yeah, cuz "F' your prices, I'll show you and die"

Not exactly awesome ADM
 
Clip4 said:
How much would like wager the majority of the country has not purchased this type of coverage?
Click to expand...

I’d agree with that statement. I was referring to coverage, as in land area, not number of people who have a membership.

Our membership only has 3 million members but they’re covered in maybe 30 % of the country. In some areas, we would be the only provider picking up that patient. In others, might be shared with another provider.
 
Velocity173 said:
Always a possibility. Of course IFR is an option in most cases.
Click to expand...

Was talking to the air ambulance guys out here. Their current helicopter is not known ice capable and due to the IFR routes over the hills to where the real hospitals are being too high apparently this one location missed out on 55 calls over this winter due to weather. Sounds like they're working to get RNAV IFR routes available at lower altitudes, probably far cheaper than new helicopters.
 
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