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

[AggieMike88]

Found an article discussing for-profit air ambulance companies.

"Through a quirk of the 1978 Airline Deregulation Act, air-ambulance operators are considered air carriers—similar to Delta Air Lines or American Airlines—and states have no power to put in place their own curbs.

Prices for emergency medical flights have increased dramatically, as air-ambulance operators expanded their networks and responded to a wider set of emergencies, including traumas, strokes and heart attacks."​

Remainder of article is interesting too.

Bloomberg article: https://www.bloomberg.com/news/feat...ked-air-ambulances-leave-behind-massive-bills

 

[AggieMike88]

Fortunately, for folks near me, CareFlight is a non-profit that offers a "membership" for $49 that protects against out of pocket expenses that insurance doesn't pay.

 

[Matthew]

There's a grade school about a block away from me. I remember, maybe 10-12 years ago, a helicopter landing in their lot. Turns out a kid was running around in the gym (or "multipurpose room") that has a carpeted floor. The kid tripped, hit his/her head and was knocked out for a short time, seconds or minutes. The helicopter flew across town to Children's Mercy Hospital. I always wondered how much that trip cost vs an ambulance ride a couple minutes in the opposite direction to the closer hospital room ER.

 

[James331]

Fake news.

 

[Shawn]

Fake news.

Not at all. Going rate for an airlift is indeed $40K and had this EXACT thing happen to a buddy who cracked his skull in his motorcycle helmet. Insurance covered ambulance rate then stuck him with the rest. A few lawsuits later they ultimately covered it but it happens.

 

[LoneAspen]

I worked with a woman once whose son had some kind of seizure out in the woods, and a flight for life type of helicopter was called in to airlift him to a hospital. Weeks later, she was telling us how her insurance didn't pay for all of it, and now they were on the hook for around $40k (IIRC). Amazing how those bills can rack up so quickly!

On another note... What is a company with "Rocky Mountain" in their name doing in Ohio?

 

[Let'sgoflying!]

Not at all. Going rate for an airlift is indeed $40K and had this EXACT thing happen to a buddy who cracked his skull in his motorcycle helmet. Insurance covered ambulance rate then stuck him with the rest. A few lawsuits later they ultimately covered it but it happens.

Happening here on a daily basis too. Have family involved in ems so I hear all the stories.
We have an inexpensive 'membership' which is supposed to cover it.
No ground option exists. You have to refuse air transport (very difficult to do) and have friend/family drive you the 3 hours to city emerg room.

 

[James331]

Oh boy.

For one many people get the statement of benefits (or whatever it's called) which is basically telling them what they are going to go after their insurance for, they confuse this with a bill for them.

Two, in my neck of the woods the average persons out of pocket, for the decent span of time we tracked, was under 1k

Three, jet A, 24/7 highly qualified flight medics and nurses and pilots well beyond ATP mins, mechanics, insurance, Med equipment and multimillion dollar aircraft don't work on hopes and dreams, I can't pour thoughts and prayers into my tanks, call it a for profit, non profit, over under profit, if it ain't in the black ink it ain't going to be around for long

Four, there is often a HUGE difference between programs, camts certification, IFR/FIKI, balloon pump, peds, etc

Five, presuming the insurance only covers $500, and the medevac company can't petition and work it out, which the good ones often can, how little brained of someone is it to blame the medevac that flew in likely under bad weather or night and NVGs to save your selfish arse, used the best crew and equipment available, they did everything right, flew because others called them and asked for help, because contrary to popular belief medevacs don't just circle around looking for people to swoop down on, they saved your arse and the insurance company who you paid every month to have your back financially incase something bad happened, well they decided to leave you high and dry, but let's blame the medevac....

So the medevac was called by your doc or EMS and came in with world class equipment and crew to help you --> evil

Your deadbeat insurance company won't pay for your care even though you paid your premiums --> nothing to see here people, move along


And six, often when a medevac is involved, the flight tends to be the smaller potatoes of your medical journey, but where's the outrage at what it costs to go to the cath lab and spend time in the ICU?

Quite frankly of anyone needs to be looked into its the entire insurance industry, and the more the government gets involved in the medical field the worse that alls going to get.

... You have to refuse air transport (very difficult to do) and have friend/family drive you the 3 hours to city emerg room.

Is that their advice for a MI, stroke or major trauma?

Unless we're just talking a broken arm or stitches that's straight Darwin Award stuff right there.

I can remember one not too bright person who's family member was having a heart attack, didn't want to be flown due to the cost, she ended up signing off on it after being told how much people actually ended up paying, and that none of the costs of the flight would roll onto them, thankfully I wasn't there, I would have told the idiot that the average out of pocket cost for the flight compared to the funeral, obit, cremation, etc costs, that it's more expensive to let the family member die, the family actually saved money not killing the loved one. Honestly some people shouldn't be allowed to breed.

 

[3393RP]

Fortunately, for folks near me, CareFlight is a non-profit that offers a "membership" for $49 that protects against out of pocket expenses that insurance doesn't pay.

I just bought a Careflite membership. It cost $145, covers all household members, and is in effect for four years. It also includes air ambulance service in a 500 mile radius from DFW.

This is a complete no-brainer. It's ten cents a day.

 

[Velocity173]

Lol! Air Methods getting bad PR? Say it isn’t so.

Flight cost has nothing to do with for-profit vs non-profit. The difference in your bill between the two is marginal. A lot of non-profits get local and state funding to help with air ambulance costs. You can bet the cost of the hospital services at the non-profit program are increased to make up for their expensive helo and better paid (most times) flight crews. Non-profits also have a smaller overhead so costs are less but they’re not the Salvation Army. They’re gonna get paid.

Flight memberships are offered for both non-profit and for-profit programs. The difference is, that non- profit might only cover that particular hospital program where as your for-profit programs are nationwide. Some counties buy for-profit flight memberships for the entire county, so everyone can fly for free.

The article seems to insinuate that we’re just scooping up patients that don’t need to be flown. First, it’s the first responder that calls for a trauma event and a physician for a hospital transfer. If they screwed up a request for a flight based on a poor diagnosis, it’s on them and not the flight crew. Also, it’s not hard to refuse either ground or air transport. We get cancelled all the time for refusals. Second, there are times when a patient could easily be ground pounded but because of county agreements such as X number of ambulances have to stay in county or if the hospital is X number of miles away, a helicopter must be called. Finally, what might seem like a minor injury externally, could actually be hiding something major (internal bleeding) that requires speed and experience. Also, the ever increasing lawsuits against medical providers for mal practice/ negligence, creates a cautious attitude in requesting a flight. If they don’t request it and the patient happens to die, they’re screwed.

The vast majority of our flights aren't minor injuries anyway. This isn’t Angel Flight. They’re either serious trauma or stroke / heart attacks. Would you rather be taken care of by a ground EMS team that might have a combined 5 years experience or one with a combined 30 years experience and actually teach the local EMS units on trauma care? Would you rather go with an EMS crew that can’t perform chest tubes, intubations, have no plasma, no ultrasound, limits on types of drugs / ability to administer, etc. etc.? When you’ve got bones sticking out of your legs or can’t speak because you’re having a stroke, would you rather take 2 hours (rural) to get to a level 1 hospital or 30 minutes?

Air ambulance is a proven service and while the percentage saved over ground ambulance is small, you’re still talking thousands every year where air ambulance made the difference. With rural hospitals closing at an alarming rate, the relevance of air ambulance and the number of patients flown is only going to increase.

 

[James331]

Id also be interested in what bloombergs owners interests in the insurance industry are

 

[Salty]

Also, it’s not hard to refuse either ground or air transport.

This is contradictory. When in the situation you would be pretty foolish to refuse it because of the rest of your paragraph below. When injured you can’t make good decisions about things like this. You’re pretty much forced to agree to it if someone suggests it because you can’t really make a good decision with the limited knowledge and time available. It’s nearly impossible for the average person to refuse. Not to mention, it is probably NOT clear to the average person that they may be on the hook for $30,000 dollars when they make that decision. They assume it will be covered. So, it is impossible to refuse, when you didn’t understand what you accepted in the first place.

Finally, what might seem like a minor injury externally, could actually be hiding something major (internal bleeding) that requires speed and experience. Also, the ever increasing lawsuits against medical providers for mal practice/ negligence, creates a cautious attitude in requesting a flight. If they don’t request it and the patient happens to die, they’re screwed.

 

[Salty]

When starting a business that is going to be prohibitively expensive, even if “altruistic” in nature, don’t you have some responsibility in figuring out how to get in covered by insurance?

It’s a little bit of “I’ll save you and you’ll pay whatever I say you pay, because, hey I saved you”.

 

[Velocity173]

This is contradictory. When in the situation you would be pretty foolish to refuse it because of the rest of your paragraph below. When injured you can’t make good decisions about things like this. You’re pretty much forced to agree to it if someone suggests it because you can’t really make a good decision with the limited knowledge and time available. It’s nearly impossible for the average person to refuse. Not to mention, it is probably NOT clear to the average person that they may be on the hook for $30,000 dollars when they make that decision. They assume it will be covered. So, it is impossible to refuse, when you didn’t understand what you accepted in the first place.

Might sound contradictory but refusal happens all the time. Can’t tell you the number of times I’ve heard over the radio that a patient is refusing either ground or air transport. Obviously there’s a discussion going on where the EMS crew / doctor is trying to convince the patient that they need transport but if they really don’t want to go, simply sign the form refusing transport.

 

[Salty]

Might sound contradictory but refusal happens all the time. Can’t tell you the number of times I’ve heard over the radio that a patient is refusing either ground or air transport. Obviously there’s a discussion going on where the EMS crew / doctor is trying to convince the patient that they need transport but if they really don’t want to go, simply sign the form refusing transport.

More times than not that has nothing to do with a rational decision based on actual facts available to the decision maker.

Don’t get me wrong here, you guys aren’t the bad guys.

But don’t pretend the people running an air evacuation business don’t have any responsibility here. They do.

 

[James331]

When starting a business that is going to be prohibitively expensive, even if “altruistic” in nature, don’t you have some responsibility in figuring out how to get in covered by insurance?

It’s a little bit of “I’ll save you and you’ll pay whatever I say you pay, because, hey I saved you”.

We should also force Mercedes to not charge much for bumpers because what if a dead beat insurance company won't pay for the bumper after a fender bender.

 

[Salty]

We should also force Mercedes to not charge much for bumpers because what if a dead beat insurance company won't pay for the bumper after a fender bender.

Bad argument.

Mercedes is not running their entire business based on something almost nobody can afford without insurance.

Your service costs more than the average person can afford. The company has part of the responsibility of figuring out how they will get paid without destroying their “patients” lives.

 

[Let'sgoflying!]

Unless we're just talking a broken arm or stitches that's straight Darwin Award stuff right there.

That's exactly what I am talking about. Well discussed in past threads on this same topic.
We have had people (stable but painful) with a broken arm etc be lifeflighted.
Our 1:00am twin roll-over 4-fatal a few years ago was a woman with a dislocated hip. A drive would have been uncomfortable, sure - but she was apparently stable too.

 

[James331]

Bad argument.

Mercedes is not running their entire business based on something almost nobody can afford without insurance.

Your service costs more than the average person can afford. The company has part of the responsibility of figuring out how they will get paid without destroying their “patients” lives.

Nope, good argument

Also we have flown Amish before, we have flown old poor people before, and the Amish have not been forced to sell their horses and buggies (even though it would be in their best interest), and grandma didn't have to sell her quilt collection, the companies work out a deal, the only time a medevac company is going to play hard ball with you is if you are a scammer, i.e. you get the check for the flight but instead of giving it to the company, you go buy a new truck.


Also you support forcing docs to only bill so much?
I mean you're looking at like $2k a day just for a bed, go in for a heat issue, need a new valve and you're looking 70k to nearly a quarter mil.

But bloomberg does go bashing cardiologists in their "news" sites.

That's exactly what I am talking about. Well discussed in past threads on this same topic.
We have had people (stable but painful) with a broken arm etc be lifeflighted.
Our 1:00am twin roll-over 4-fatal a few years ago was a woman with a dislocated hip. A drive would have been uncomfortable, sure - but she was apparently stable too.

And this is the medevacs fault how?

They don't self dispatch.....

When you get in a major accident just keep yelling your top dollar amount you're willing to see a invoice for for saving your life lol

 

[kayoh190]

And this is the medevacs fault how?

They don't self dispatch.....

Seems to me this is the crux of it. The medevac company is no different than any other 135 operator - they fly people around on demand in exchange for money. If someone wants to make an argument that the system is broken, fine - but the fingers should be pointing somewhere else IMO.

 

[Velocity173]

More times than not that has nothing to do with a rational decision based on actual facts available to the decision maker.

Don’t get me wrong here, you guys aren’t the bad guys.

But don’t pretend the people running an air evacuation business don’t have any responsibility here. They do.

And again, the decision to request air transport isn’t made by any air ambulance company anywhere in the US. They are completely out of the loop in that process. The first responder (scene) or the transferring & receiving physicians (hospital) make that decision. As I said, that decision has many variables involved and the responding air ambulance has no authority in overruling that process.

 

[NoHeat]

It’s all just another example of how health care in America is afflicted by a patchwork ownership and management, and how it is ridiculously complicated, confusing, and so very expensive for ordinary people.

 

[James331]

It’s all just another example of how health care in America is afflicted by a patchwork ownership and management, and how it is ridiculously complicated, confusing, and so very expensive for ordinary people.

Would be much easier if people got government less involved in it.

 

[N659HB]

If you're not happy with US healthcare, move to Canada.

 

[Rykymus]

If you're not happy with US healthcare, move to Canada.

Yeah, that's a great solution. Thanks for your contribution.

Seriously, the US has the best healthcare in the world, as long as you're in the 10% that can afford to pay for it, or the 40% that qualify for subsidy.

We recently dumped our insurance and put the money into a separate checking account to use for healthcare expenses. We joined a concierge medical practice where we pay $100/mo each for unlimited access to the doctor. I had an MRI on my knee the other day. The bill showed both the cost if insurance was being billed (which it wasn't) and the cost if paying cash. $2600 if insured or $350 cash. If we had still been covered, we would have had a $500 copay. Tell me there isn't something wrong with that.

If one of the local hospitals would just offer membership, I'd jump on it. I hate the entire concept of healthcare insurance.

 

[Sac Arrow]

Other countries seem to be able to pull it together. India. Vietnam. Thailand. And to a great extent Australia. It's the insurance industry that takes the largest chunk of healthcare costs.

I had a motorcycle accident that nearly killed me a few years ago. Two ambulance rides totaled $10,000 in billed costs to insurance (and a $1,000 copay from me) and the total bill was around $50K for two days of ER treatment. The same thing in Vietnam would total less than $500. And yes, they have good doctors and modern equipment.

 

[James331]

Yeah, that's a great solution. Thanks for your contribution.

Seriously, the US has the best healthcare in the world, as long as you're in the 10% that can afford to pay for it, or the 40% that qualify for subsidy.

We recently dumped our insurance and put the money into a separate checking account to use for healthcare expenses. We joined a concierge medical practice where we pay $100/mo each for unlimited access to the doctor. I had an MRI on my knee the other day. The bill showed both the cost if insurance was being billed (which it wasn't) and the cost if paying cash. $2600 if insured or $350 cash. If we had still been covered, we would have had a $500 copay. Tell me there isn't something wrong with that.

If one of the local hospitals would just offer membership, I'd jump on it. I hate the entire concept of healthcare insurance.

Uhhhh no

If I were a bum who got hit by a car, I'd much rather it happen in the US than Canada

Side note, if a homeless person got hit by a car or something and EMS calls for a medevac, we still respond with the same force and speed as if it were a 1%er liberal in a Tesla, same deal in the ER, they will stabilize/save you just the same regardless of if you can pay, it's even posted in every ER I've been in, and that's quite a few

If you're a middle class guy who can't afford insurance but still makes OK money, they'll negotiate the price and make a payment plan, heck as long as you try to pay them they ain't going to try to destroy your life.



Here's a nice comparison on the US vs Canadas health system, actually done by a Canadian living in the US

 

[weilke]

A big problem in the medevac industry is the lack of good faith negotiations between the insurers and the few providers that dominate the industry on the provider side. The first thing that should probably happen is to carve medevac out of the air carrier act and make the industry accountable to someone.

The level of charges is absurd relative to the cost of providing the service and the hardball tactics used to collect should be reigned in.

In MD, all trauma related medevac is provided by the state using a $15 fee levied on car registrations. While I disagree with many details of how it is implemented, the system eliminates some of the robbery tactics employed in the for profit medevac industry. IHT is done by the hospitals and there are still lots of shenanigans happening. But at least it is easier to evaluate the medical necessity in a hospital than in a wreck by the side of the highway.

 

[wsuffa]

Medivac is expensive.

But look at the ER costs. A local hospital contracts with a local doctor's group to provide MDs for the ER. I saw a recent bill - for less than 10 minutes of the doc's time, the doctors group billed over $3,000 (and that was the insurance-negotiated rate) and was not covered under the insurance policy. The ER itself billed for supplies, nurses, etc. which was fully covered by insurance. That was less than $1,000.

I get that doc's time is valuable. But $3,000 for 10 minute? $18,000 per hour? Sorry, that's out of line.

 

[James331]

A big problem in the medevac industry is the lack of good faith negotiations between the insurers and the few providers that dominate the industry on the provider side. The first thing that should probably happen is to carve medevac out of the air carrier act and make the industry accountable to someone.

The level of charges is absurd relative to the cost of providing the service and the hardball tactics used to collect should be reigned in.

In MD, all trauma related medevac is provided by the state using a $15 fee levied on car registrations. While I disagree with many details of how it is implemented, the system eliminates some of the robbery tactics employed in the for profit medevac industry. IHT is done by the hospitals and there are still lots of shenanigans happening. But at least it is easier to evaluate the medical necessity in a hospital than in a wreck by the side of the highway.

I agree the insurance industry should be made accountable, but they were never in the air carrier act so I'm not sure what you're talking about.


Also please tell me what the government should allow myself and my colleges to be paid, go for it force your prices on us and when you and your wife pile that car into a guard rail and you're looking at her gasping for air with blood all over, or when Mom has that stroke out in a national park, brother you ain't going to be getting the best of the best coming in on a highly equipped flying ICU, NOOOOPE! But enjoy that basic EMT, 500hr helicopter pilot, first responder who's still kinda hung over, and ratted out R66 that's going to come to your rescue with BLS supplies, well if bubba remembered to restock, I mean at $15hr he's working 3 jobs.


OR.....focus on that insurance industry who's ALWAYS there to collect their premiums or sell you some more insurance, but acts totally different when it's time for the money to flow in the opposite direction.

 

[Velocity173]

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.

 

[luvflyin]

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.

HEY!! Get your head out of the cockpit. Or on the panel or sumpin

 

[James331]

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.

Plus the level of care.

 

[Morgan3820]

I live near a Marine air base. Medevac used to be covered by the Marine helicopter Pedro as a training mission for free. The medevac businesses complained. Pedro no longer flies civilians. And Pedro would fly at night. Land on bridges, anywhere. Now EastCare charges $$$. Love the Marines.

I think that I'll just pick up my severed arm and drive myself.

 

[weilke]

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.

What was your time from decision to call for medevac to arrival on the scene ?

 

[James331]

I live near a Marine air base. Medevac used to be covered by the Marine helicopter Pedro as a training mission for free. The medevac businesses complained. Pedro no longer flies civilians. And Pedro would fly at night. Land on bridges, anywhere. Now EastCare charges $$$. Love the Marines.

I think that I'll just pick up my severed arm and drive myself.

We have something similar, great for hoist recuses or trauma, but not so much for non trauma heavy medical stuff, get someone I'm a rural ICU that needs a higher level of care NOW, who's on 3 drips and a vent, or god forbid a lvad or balloon pump

 

[Velocity173]

HEY!! Get your head out of the cockpit. Or on the panel or sumpin

Lol! I was watching golf at the hospital when I typed that.

 

[Velocity173]

What was your time from decision to call for medevac to arrival on the scene ?

11 minutes. Beat the ambulance to the rendezvous (scene) as well.

 

[Katamarino]

$50,000 for 37 minutes flight time, not bad!

 

[paflyer]

If 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.