Ambulance Cost

• Ambulance service typically is covered by health insurance when medically necessary. For example, BlueCross BlueShield of Alabama[1] offers coverage for medically necessary ambulance transport, to the nearest facility that can treat the patient, on many policies. For patients with health insurance, out-of-pocket costs for ambulance service typically consist of a copay of $15 to $100 or more or coinsurance of 10% to 50%. Some ambulance service providers will "balance bill" -- bill the patient for the remainder of the bill above what the insurance company pays, if they don't have a contract with that insurance company; some states have outlawed this practice. According to Woodburn Ambulance Service in Woodburn, OR, their patients with commercial insurance pay an average of $432 out of pocket.
• For patients without health insurance, ambulance service cost typically depends on location, whether the trip is for an emergency or scheduled transport, how many miles the patient travels and whether basic life support or advanced life support is needed. The cost can be nothing out-of-pocket in cities where services are covered by taxes, but usually ranges from less than $400 to $1,200 or more plus mileage. For example, in Lima, OH, taxes pay for any ambulance services not covered by insurance, so residents do not receive a bill. The city of LeMars, IA, charges $375 for non-emergency basic life support service up to $600 for emergency service with advanced life support. The city of Urbana, OH, charges $650. The city of Nichols Hills, OK[2] , offers a membership plan for $2.50 per month for ambulance rides at no out-of-pocket cost, but non-members pay $1,100 plus $9 per mile for ambulance service. Woodburn Ambulance Service in Woodburn, OR, offers a membership plan, but non-members pay $1,220 plus $20 per mile per trip.

• In an emergency, the ambulance provider that services the location typically will respond immediately to a call. The dispatcher will determine if only emergency medical technicians are needed, for basic life support, or if paramedics are needed, for advanced life support.
• The ambulance crew will assess the patient's medical condition and check vital signs such as pulse, blood pressure and respiratory rate, and will determine if transport to a nearby hospital emergency room is needed. If so, the crew will provide needed care during the ambulance ride. Basic life support care, typically for non-life-threatening emergencies, includes minor treatment, continued monitoring, and possibly administration of oxygen. Advanced life support care, for life-threatening emergencies, also can include CPR, administration of medication, breathing tube insertion and other needed treatments.

• Medical supplies -- for example, sterile gloves, needles, IV supplies, catheters, and saline -- used during the trip can add hundreds or even thousands of dollars to the final bill. For example, providers in Los Angeles County[3] can charge $24.75 for an oxygen mask, as well as for bandages, dressings ice packs; they can charge $45.25 for a burn kit or obstetrical kit; and can charge $80.25 for an infusion pump or pulse oximeter.
• If a critical care nurse or respiratory therapist is required during an ambulance ride, it can add hundreds of dollars to the cost.

• Some providers will negotiate a discount of up to 20% or more for uninsured patients who pay cash or pay within a certain timeframe. For example, Lincoln County Ambulance Service[4] in Kansas offers a 20% discount for payment within 30 days and a 10% discount to uninsured patients. And Woodburn Ambulance Service in Oregon offers a 10% discount for payment made within 30 days of service.

• The American College of Emergency Physicians Foundation[5] offers a guide to when to call an ambulance in an emergency. In a 9-1-1 emergency, the ambulance provider that services that location will respond; in some locations, there is more than one provider and it might be possible to request a certain provider.
• For a scheduled transport, a hospital or physician should be able to provide a referral for an ambulance service. Or, the American Ambulance Association[6] offers a provider directory by state and city.

1.  /www.bcbsal.org/providers/helpful/Ambulance%20Coverage%20Policy.cfm
2.  www.nicholshills.net/SectionIndex.asp?SectionID=85
3.  fire.ci.glendale.ca.us/pdf/AmbulanceRates070110.pdf
4.  www.lincolncoks.com/Ambulance/GeneralInformation/PatientBilling/FinancialAssistanc...
5.  www.EmergencyCareforYou.org/EmergencyManual/IsItAnEmergency/Default.aspx?id=130
6.  www.the-aaa.org/DIRECTORY/memberlocator.asp

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