by the transplant center physicians . The decision on whether transportation by commercial aircraft or by air ambulance thus becomes a medical decision – and a financial one .
There has been a proliferation of companies offering private air ambulance services . The acquisition and maintenance cost of such aircraft , especially ones outfitted as flying intensive care units is expensive . Then there are the costs of pilots and medical personnel who must be on-call , whether flying or not . Typical prices for air ambulance services range from $ 20,000 to $ 50,000 . The Kaiser Family Foundation News reported in 2022 on a 32-year-old man from North Carolina who was on his honeymoon in a distant state when he fell ill and was found to have acute leukemia . He wanted to return home for treatment with hospitals in his health plan network . The local doctors advised against commercial travel because of COVID-19 ; and recommended air ambulance . That particular service was out of network for his health plan , as were the surface ambulances taking him to and from the airports . He received combined bills for $ 489,000 — something the newlyweds could not pay at all . It took press coverage for his health plan and the air ambulance company to come to the table and negotiate a settlement . 2
A 2019 Report to Congressional Committees by the General Accounting Office ( GAO ) found that in 2017 , two-thirds of air transport cases were out of network for the patients ’ insurance plan . 3 This includes both helicopter and fixed-wing air ambulance services . This is at a time that there has been an expansion of helicopter air ambulance services going from 752 air ambulance-based locations in 2012 , to 868 in 2017 . Likewise , over that same five-year period the number of fixed-wing bases increased from 146 to 182 bases . The majority of those were in states from the Rocky Mountains to the West Coast . Not uncommonly , jet air ambulance services to and from Louisville are with aircraft based in California or Arizona .
Let ’ s get right down to brass tacks . You may well be planning a summer vacation and wonder about what would happen if you or your family member were to need high-level medical care . If you are going to an urban area in this country , appropriate care can be readily found . In most rural areas , surface ambulances can provide safe transport to a local hospital for stabilization . If needed , ambulances can often get you to a more advanced hospital . Helicopter transport is commonly used when the time or terrain are just not appropriate for transport by surface ambulance . The average helicopter trip is 52 miles and can cost $ 12,000 to $ 25,000 per flight . This high cost is to amortize the cost of a helicopter , that can run up to $ 6 million .
Air ambulance by fixed-wing jet was averaging $ 41,674 in 2017 . But it is not uncommon for jet air transport to reach $ 200,000 based upon distance , urgency and equipment on board . At least one company has a jet with hyperbaric oxygen chamber to transport divers who experience the “ bends ” while diving in another country . Clearly , the majority of tourists never need such transport ; but it is a possibility .
For senior physicians who have Medicare , air transport may be covered for medically necessary care where a surface ambulance is not reasonable / feasible . The test of what is reasonable is spelled out in Medicare Benefit Policy Manual ( Chapter 10 , 30.1.2.2 Air Ambulance Services ). When it is covered by Medicare , air ambulance is only to the closest hospital capable of handling the condition . However , Medicare does not transport patients who are in another country to bring them back to the U . S .
Most patients with commercial insurance just don ’ t know what is covered in their own policies . Some health insurance plan policies may provide some coverage for transportation . Physicians anticipating travel out of the country should verify what coverage for surface or air ambulance is provided in their health benefit plans . Often , such policies do have significant limitations .
There are a number of travel insurances that can be purchased for individuals or groups that provide air ambulance coverage . Forbes Advisor recently published a review of policies . They vary on the “ medical expense and evacuation limits ,” but typically include such other benefits as trip interruptions , lost baggage , travel delay , kennel coverage and others . These additional “ benefits ” may drive up the costs of such policies . My own experience in pricing a mid-level policy for one week abroad was over a thousand dollars . The frequency that a physician traveling needs such insurance is small , but the price can be high if one is needed .
References :
Medicare Benefit Policy Manual , Chapter 10 — Ambulance Services
2 . Rotary Wing Air Ambulance ( RW ) Rotary wing air ambulance is furnished when the beneficiary ’ s medical condition is such that transport by ground ambulance , in whole or in part , is not appropriate . Generally , transport by rotary wing air ambulance may be necessary because the beneficiary ’ s condition requires rapid transport to a treatment facility , and either great distances or other obstacles , e . g ., heavy traffic , preclude such rapid delivery to the nearest appropriate facility . Transport by rotary wing air ambulance may also be necessary because the beneficiary is inaccessible by a ground or water ambulance vehicle .
1
Travel in Pregnancy , American College of Obstetricians and Gynecologists https :// www . acog . org / womens-health / faqs / travel-during-pregnancy #:~: text = - Most % 20airlines % 20allow % 20pregnant % 20women , Check % 20with % 20your % 20 airline . ( Last read April 11 , 2023 )
2
The Case of the $ 489,000 Air Ambulance Ride , Julie Appleby , Kaiser Family Foundation Health News , MARCH 25 , 2022 https :// kffhealthnews . org / news / article / the-case-of-the-489000-air-ambulance-ride / ( Last read April 11 , 2023 )
3
Air Ambulance , Available Data Show Privately-Insured Patients are at Financial Risk . United States Government Accountability Office report to Congressional Committees , March 2019
4
Understand Air Ambulance Coverage , National Association of Insurance Commissioners , Consumer Alert : https :// insurance . ky . gov / ppc / Documents / naicalertairambulance110514 . pdf
5
Best Senior Travel Insurance 2023 , Jason Met Editor , Forbes Advisor , updated Oct 18 , 2022 , https :// www . forbes . com / advisor / l / senior-traveli nsurance /? utm _ content = TI _ 65 + Age _ Compare _ Broad & utm _ term = travel % 20insurance % 20 comparison Broad & gad = 1 & gclid = CjwKCAjwrpOiBhBVEiwA _ 473dK9D _ IuvQrjgJqUbiUnWPfZ2iicSwQdbbHrsfqiemuMifd2Rm3bpQhoCWpUQAvD _ BwE & gclsrc = aw . ds
Dr . James is the Chief Medical Officer for Passport Health Plan by Molina Healthcare .
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