Consumer Alert: Air ambulance services in Montana raise concern

csimt Uncategorized

Montana Insurance Commissioner Monica J. Lindeen issued a consumer advisory Thursday, alerting Montanans to issues with private air ambulance services and encouraging Montanans to investigate the services thoroughly before signing a contract with one.

Lindeen’s office has received numerous complaints from Montanans who were transported by a private air ambulance service and were later billed many tens of thousands of dollars after their insurance company did not cover the cost of the ambulance ride.

Many Montana hospitals have their own air ambulance service. These services are in a health insurance company’s network and are covered by insurance. However, many stand-alone air ambulance services are not part of an insurance company network and those fees are not covered by insurance.  As a consequence, Montanans who are transported by private air ambulance services receive a “balance bill” for the amount insurance will not cover.

These bills have exceeded $55,000 and insurance is not contractually obligated to pay them.

Some private air ambulance carriers have begun marketing membership programs directly to Montanans. These “memberships” will cover the cost of the amount insurance will not pay.

However, there are many factors Montanans should take into account when considering private air ambulance membership:

Is It Necessary? Many air ambulance providers, like most other health care providers, already participate in health insurance provider networks. These air ambulance providers accept a pre-negotiated in-network rate for services provided. Patients who are transported by an in-network air ambulance provider cannot be balance billed, even if they don’t have an air ambulance membership.

What Does it Cover? Air ambulance providers have limited geographic coverage areas. This means that, depending upon a patient’s location when he or she is transported, the membership provider may not provide the transportation. As a result, the air ambulance provider who performed the flight may still balance bill for it, even though the patient has a membership.

How Will My Doctor Know I Have a Membership? Patients generally cannot control whether a membership provider performs their airlift.  Often, the patient is unconscious or otherwise unable to inform emergency personnel they have an air ambulance membership. Therefore, purchasing a membership does not guarantee the membership provider will provide the flight, even if the provider is available.

Air ambulance provider billing practices, including membership programs, are currently under investigation by the Economic Affairs Interim Committee of the Montana Legislature. 

Lindeen’s office is actively participating in the committee’s efforts.  If you have further questions, please contact the Policy Holder Services Division at the Montana State Auditor’s Office at 1-800-332-6148.