As surprising as this maybe, air ambulances are not classified as a medical expense. Due to the deregulation act of 1978, air ambulances are classified as a common carrier. The FAA is the only governing body, which means that any Department of Insurance for any state, Medicare, Tricare, VA, the ACA, or private insurance companies have as much influence over the air ambulance prices as they would telling Southwest or Delta airlines how much they can charge per ticket.
In 2020, the average charge of an air ambulance was $52,481.30. The average charge of a ground ambulance was $1,162.50. To put this in perspective, the average individual income in in 2020 was $43,894.00.
Approximately, 67% of all air ambulances are a hospital-to-hospital transfer. 33% are the ambulance picking you up at the scene of the illness or injury.
As you may know: It isn’t up to you, it isn’t even up to the EMT or physician that was live on the scene, it is up to the insurance company that gets to play Monday morning quarterback and gets to take their time and review all medical records to determine if your emergency transportation was medically necessary.
All physicians take an oath to try to preserve life. So, if the doctor determines on the spot that you have a greater survival rate if you were to be transferred to a more equipped hospital, more often than not, they are going to request the transfer. But the system is set up against you. Before they complete the transfer, they are going to have you or a loved one sign an ABN form, which stands for Advanced Beneficiary Notice of Noncoverage, making you 100% financially responsible for the helicopter if your insurance denies it.
The insurance companies take a completely different approach: They want to protect the company against overages, so they hire people to read thru all the medical records to see:
1. Would you have survived if you stayed at the original facility?
2. Did you receive any treatment that was not available at the original facility?
3. Were you transferred to the nearest appropriate facility?
Those are just three of several reasons an insurance company can deny the claim. Again, the system is rigged against you and insurance companies write it into their policies. Have you ever noticed that insurance companies state that they “may” cover this benefit but does state that they “will” cover it? It is because the insurance company MAY not want to pay the claim. In a typical year, more than 25% of all adult transfers to a level 1 trauma are denied and over 50% of all kid transfers are denied.
The need for air ambulances is based on the concept of the “golden hour” where if you suffer a serious illness/injury/or medical event, you have the greatest chance of survival if you get to the right medical facility within 60 minutes.
There are 5 different levels of trauma centers in the US. Level one being the best. There are several areas within the continental United States that getting to a level one trauma without an air ambulance is not possible.
Due to the need and the unique economic model, air ambulance companies rig the game against everyone. There are about 550,000 air ambulance claims per year. So, private equity firms have been buying into the nearly $30 Billion dollar industry and do not have to disclose earnings.
In normal economic models, the more companies or competition there is the less expensive something becomes because demand is spread out. Over the years there have been more and more companies getting into the air ambulance business. However, if you need an air ambulance, the need is immediate, and you do not have the opportunity to shop around. Therefore, air ambulance companies have an incredibly unique economic model.
Again, air ambulance companies are not classified as a medical expense and do not have to play by insurance company rules; in fact 77% of all air ambulance claims are billed out of network further pushing the cost to the consumer and not the insurance company.
So, what can you do to protect you and your family?
Don’t rely 100% on your major medical plan alone. My number one major medical add on for my clients is MASA, which stands for Medical Air Services Association. My favorite part is that this is an association, not insurance. I think we determined that insurance companies deny claims every now and again. I’ve said that for years and oddly enough, I’ve never had anyone argue with me about that. But associations are different. Have you ever heard of AAA refusing to change someone’s tire? Or someone not getting their 15% discount at Denny’s by being an AARP member? No. It is because associations say what they do and do what they say. MASA’s moto is Any Ground. Any Air. Anywhere.
Masa Covers Air ambulance, Ground ambulance and a slew of other benefits you may never have heard of or thought of!
A lot of people think they only need this coverage if they travel, but that simply is not true: 90% of all emergencies happen withing 5 miles of your home, which makes sense since you spend 90% of your time within 5 miles of your home. With MASA there are no deductibles, no claim forms, no networks, no health questions, no dollar limits, or no age limits!
You can go to https://insurityfinancialservices.com/masa-coverage today and sign up in 3 easy steps! Step one, watch the video “peace of mind for small town America”. Step two is to sign up with ASBA which is a free discount program, and you can get up to a 40% discount off your premium.
The three levels are Platinum where you pay monthly for the coverage. This is set up by an automatic payment via bank info or debit/credit card. The cost is $27/mo for an individual or $35/mo for the whole family!
Elite 5 year gives you an opportunity to pay up front and get 5 years’ worth of coverage for the price of 4.5. $1,305 for individual and $1,755 for a family plan.
And if you are over the age 50, you have an opportunity to make 1 payment and get all these benefits for a lifetime. Note, this is NOT like a timeshare and this truly is one payment, and you will not have any hidden blah, blah, blah fees in the future! $2,900 for individual and $3,900 for a family plan.
If you chose the 5 year or lifetime membership, you do get more for less: MASA will provide a travel advisor, physician search, professional translator and you would also receive a MYID bracelet.
Once your application is received, Insurity Financial Services will process it and you will get an email from MASA with you member ID number, and you will receive your welcome packet in 3-4 weeks with a wallet sized card you can carry with you.
