posted May 24, 2024

Idahoans don’t need to fear the bill that comes with a medical emergency 

SALMON, ID, MAY 24, 2024 – There was a time when horror stories about the cost of air ambulance service had people not only fearing a medical emergency, but also sweating over how to pay the bills that were sure to follow. To help avoid a large, unexpected bill, Idahoans were encouraged to pay a monthly or annual fee for a membership with an air medical transport provider. Air medical memberships are an unregulated type of insurance, covering a service that is highly unlikely to ever be needed by most people. Thankfully those days are gone. When an emergency strikes, people no longer face huge air ambulance bills and don’t need to pay for memberships either.  

When Congress passed the “No Surprises Act” in 2021, it put an end to surprise medical billing. Under the Act, which went into effect on January 1, 2022, insured patients are only responsible for their deductible, copay, or coinsurance up to the maximum out-of-pocket amount listed in their policies. It doesn’t matter who the insurance provider is, what air medical service is used, or if the provider is in or out of network – patients cannot be charged more than the maximum out-of-pocket agreed to in their policy. 

Additionally, emergency air medical transportation is a covered benefit for people with Medicare Part B or Medicaid. Patients with Medicaid have no deductible, and those with Medicare commonly carry supplemental (“Medigap”) policies that cover deductibles, copays, or coinsurance for air medical services. 

Last July, Todd Simmons was working on his ranch in Birch Creek when blood clots blocked the main vessel in his heart, causing a heart attack. His wife was 40 miles away at their home in Mud Lake when she got the call that her husband was in trouble. 

“There are no services in Birch Creek,” said Paulynn Simmons. “He was driven in one vehicle to Mud Lake where he could meet the ambulance, then the ambulance drove to where they could meet the Air Idaho Rescue helicopter. It took about 45 minutes.”  

This was Todd Simmons’ eighth heart attack, so the Air Idaho Rescue clinical team provided life-saving care while transporting him to East Idaho Regional Medical Center (EIRMC) where he underwent a delicate procedure to carefully remove the clots and was able to return home within a couple of days. 

“We had a membership with a different air ambulance company, but they don’t fly to EIRMC,” said Paulynn Simmons.” When her bills from Air Idaho Rescue arrived, she called their patient advocacy department who worked with her to determine an amount she could afford. 

“Our cost for the flight was over $63,000, and their health insurance paid $12,783.18,” said Jeff Loew, patient relations supervisor with Air Methods, the parent company of Air Idaho Rescue. “Under the No Surprises Act, patients are not responsible for that difference. We work that out with the insurance company without putting the patient in the middle. In this case, under the Simmons’ insurance plan, they were responsible for a deductible and co-insurance totaling $5,942.22, but they contacted us and worked with a patient advocate who reviewed their financial circumstances, and we were able to reduce their bill to only $2,000.”   

Paulynn Simmons was very happy with this resolution. 

“They got the bill down to $2,000 and I felt good about that,” said Simmons. “When I called, the woman I spoke with was very nice and we got it resolved that day. I did it over the phone and it was done.” 

Several air medical providers operate in Idaho, and their different business models have led to some misconceptions about how air medical transportation billing and insurance works. All air medical service providers, whether they are for-profit or not-for-profit, charge for their services. Idahoans with health insurance, including Medicare, Medicaid, and VA coverage, are encouraged to call their insurance providers to discuss possible charges should air medical transport ever be needed. 

When Steve McCain’s wife, Debra, needed emergency air medical transport, the cost of the flight was $86,999. Their insurance paid $9,794.88, so Steve contacted the Air Methods patient advocates. 

“When the bill came showing what the insurance paid and what was owed, I emailed the patient advocates and the response was excellent,” said Steve McCain. “They were polite, they answered my questions, and they informed us that Debra’s insurance deductible was only $250.”  

The McCain family was on vacation and fishing on the Salmon River above the Stanley-Sunbeam area when Debra had a grand mal seizure and stopped breathing. As a first aid instructor, Steve thankfully knew what to do until help arrived. An ambulance took Debra to an Air Idaho Rescue helicopter that transported her to Boise. The couple had a membership with a different air medical provider that didn’t serve the Stanley area. Because there was a 4^th of July event in the area, the roads were packed and the helicopter was the best way to quickly get Debra to the care she needed. 

Air Methods, which operates Air Idaho Rescue bases in Salmon, Idaho Falls, Driggs, and West Yellowstone, MT, is in network with most major insurance companies, so patients typically do not get a bill for air transport because their insurance covers the cost. For patients without health insurance, Air Methods’ patient advocacy department works one-on-one with individuals to ensure affordability based on their own financial circumstances. Between being in network with the insurance carriers and offering robust patient advocacy, there is no reason for people to pay for an air medical membership they may never use, particularly when the chances of ever needing it are exceptionally rare. 

Additionally, air medical companies do not self-dispatch, meaning neither the air medical company nor the patient can control which provider is called in an emergency. When critical medical care is needed urgently, the closest available aircraft should be dispatched, and patients should never delay care by waiting for a specific carrier based on memberships. 

“We believe that when someone suffers from a serious illness or injury, they deserve to focus on their recovery rather the bill,” said Loew. “We do all we can to make the process as easy as possible for our patients and their families.”