Most consumers believe their health insurance coverage will provide benefits when requiring air transport in response to a medical event. Their expectation is when they are injured while traveling for either pleasure or business or if medical care is need in an emergency their health insurance policy will cover the expense to contract for medical air transportation.
In well-defined instances, health insurance coverage will provide benefits for medical air transport but there are many factors to consider when determining the level of coverage and how your specific need will be addressed.
What is medical air transport?
It is the deployment of any type of aircraft, (fixed wing plane or helicopter) outfitted with medical equipment and medical personnel to transport a patient to a medical facility and provide medical care during the time of transport. Medical air transport is used when either distance or the nature of the patient’s condition eliminates other forms of transportation. According to the Association of Air Medical Services, more than 550,000 patients in the U.S. use air ambulance services every year.
Typically, consumers think of medical air transport being used in an emergency, but the service can also be provided to return a patient to their hometown or to provide transportation to a medical facility for specialized treatment and the distance precludes ground transportation.
Medical Air Transport and the Affordable Care Act (ACA)
The Affordable Health Care Act (ACA) provides for medical air transport benefits as a component of the plan’s essential benefits but there is a significant qualifier to access the benefit. Use of medical air transport must be deemed to be medically necessary. Medically necessary is defined as medical care required to prevent, diagnose, or treat an illness, injury, condition, or disease according to current medical standards. The key in determining medical necessity is the attending physician’s justification to order air transport to treat the patient’s condition in comparison to other options, which can include remaining in the current facility for additional treatment. Even though the physician may order air transport, the insurance carrier can request a review by their medical director to determine whether the request is justified. What is immediately obvious is the delay and bureaucracy that must be negotiated at a time when there are more pressing matters such as medical care of a family member.
The cost associated with medical air transport will be subject to your plan deductible and maximum out-of-pocket. It is imperative that you confirm that the medical air transport service is covered by your health insurance carrier. Plans under the ACA are predominantly Health Maintenance Organization (HMO) plans and provide no out-of-network benefits. If you select a medical air transport provider that is out-of-network, you will be responsible for full charges because the negotiated rate is not applicable to out-of-network services.
When insurance carriers pay benefits related to medical air transport they may pay what they define as reasonable and customary charges. This reimbursement may not compensate the medical air transport provider in full and the balance of the bill may be the responsibility of the insured, which can run into the thousands of dollars. The average medical air transport charge is between $12,000 to $25,000 per flight. The charge for the service takes into account the purchase price of the aircraft, ongoing maintenance costs, on board medical equipment, medical personnel which can reach $6 million as well as medical equipment and maintenance. Also factoring into the price is the cost of round-the-clock availability for specially-qualified medical personnel and pilots to take flight at a moment’s notice.
How to Prepare For the Unexpected
Air medical transport has come a long way from being a term that represented military transportation for the wounded soldiers. Even though the term traditionally was linked to the heroic missions performed by the military, over the years it has come to encompass critical patient transportation.
Now air medical transport services incorporate critical care medical equipment, specialized medical staff and state-of-the-art aircraft, which enable complete medical care of patients in-flight. Today, air medical evacuation and transport services have expanded the reach of critical care and other specialized patient care units beyond an individual hospital facility across the globe.
Select An Accredited Air Medical Transport Service
Stateside Insurance Services researched numerous providers of air medical services and discovered that an important component was found in the accreditation and licensing of air ambulance providers. Accreditation is important because it affirms the provider adheres to worldwide safety standards for ground interfacility and air medical transport systems. By adhering to the rigorous standards established by the accrediting agencies, the highest possible patient care is ensured.
There were several factors that Stateside discovered during the evaluation of AirMed as a provider of air medical services. AirMed is accredited with the Commission on Accreditation of Medical Transport Systems (CAMTS), the European Aero-Medical Institute (EURAMI) and the U.S. Department of Defense. AirMed through these accreditation programs meets the safety requirements, safety standards and patient care. An example of the reputation earned by AirMed was recognition by top hospitals in the U.S. including the world-renowned Mayo Clinic as the most trusted fixed-wing air medical transport service.
AirMed transport team consists of a certified flight crew, licensed medical specialists, 24/7 mission response center with extensively trained professionals and fully equipped medical aircraft, which specifically operate for air med evacuation missions.
AirMed provides the following services:
- Domestic and international aeromedical transport service to 150+ countries around the world.
- Unparalleled and comprehensive medical evacuation and medical repatriation services.
- Part 135 ATP certified flight crew and extensively trained licensed medical crew consisting of critical care flight medics, physicians and nurses.
- Medically configured fixed-wing aircrafts with mission essential equipment including stretcher, oxygen, monitors, ventilators, neonatal equipment and required medications.
- Multiple levels of critical medical care available on every jet for long-distance aeromedical evacuation transportation.
- 24/7 mission response center staffed with highly skilled professionals with access to medical specialists and consultation physicians.
- Assistance with medical clearance, hospital admissions, ground transportation, commercial medical escorts and fly-to-fly status verification.
- Specialized bedside to bedside services, neonatal medical transportation and certified commercial medical escorts to provide continued patient care.
AirMed has 25 years of experience in air medical transport service, completed over 18,000 missions, offered the highest level of care and comprehensive aeromedical evacuation services in 250 cities around the world.
Annual Plans give residents of the United States and Canada premier access to the ultimate air medical transportation services, on call 24 hours a day, whenever a member is traveling 150 miles or more from home. When traveling outside your country of residence, services are available provided you don’t spend more than 90 consecutive days outside the country per membership year.
The following hyperlink provides additional information on the various coverage options that are available: AirMed International