There’s no getting away from it, once you call 911 for an ambulance, you’re going to get billed for their time and effort, at least, assuming you live in the United States. But what’s that going to look like and how much will you be expected to pay?
For an ordinary ambulance, the average cost is $1,211 for a single trip. If you need an air ambulance it might be closer to $40,000! Though these prices can vary greatly and many times the costs will be covered by your health insurance.
Let’s take a look at why that should be the case and how much of that bill you might need to pay out of your own pocket, even if you are insured.
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How Much Does It Cost To Call An Ambulance?
Firstly, it’s important to establish that for the purposes of this article, we’re dealing with the cost of calling an ambulance within the United States.
If you call an ambulance in the UK, for example, and assuming you are a legal resident, it doesn’t cost you anything, unless you’re adjudged to be deliberately wasting the ambulance’s time. This is the result of the UK having a socialized health care system.
And in other countries that charge for ambulances, the costs can vary dramatically from the United States.
So, in the United States, according to Medicare, the average cost of an ambulance ride was $1,211 per trip in 2019.
However, this is an average. We’ve found a wildly varying set of figures for individual callouts including those that ran close to $5,000 for an ambulance journey!
That means that the costs can be very different depending on the exact nature of your emergency and where you live, as well as which ambulance provider responds to your call.
Beware Of Surprise Ambulance Costs
Over at Financial Samurai, they detail the cost of calling an ambulance for one mother when their young daughter needed one in an emergency.
Despite having a platinum PPO plan with United Healthcare, the mother found that she had to pay $3,352 out of her own pocket on a $4,250 ambulance bill!
Obviously, this was completely unexpected and while the mother, after months of persistent battling, did manage to get this bill reduced, it’s fair to say that you cannot rely on being able to get a reduction from an ambulance service.
Are Ambulance Costs Covered By Health Insurance?
Maybe. In fact, this could come as a huge shock even to those folks with amazing levels of health insurance.
Research suggests that over 70% of ambulance service providers in the United States do not accept insurance at all! Yes, there’s a 7 in 10 chance that you might have to foot the entire bill for your ambulance ride yourself, even with top-tier health insurance in your pocket.
Then, we can take a look at our surprise ambulance bill case above. Here the provider did accept an insurance payout and the mother had excellent insurance.
However, the insurer treated the claim as though it were “out-of-network” which meant there was a cap on how much they would payout. In fact, they would only cover $898 of the bill!
The mother then had to pay a 20% copay on this amount ($180).
This meant that the insurer only paid $718 in total.
And the ambulance provider, while happy to take this check, then pursued the mother for the difference between their invoice and the insurer’s payment!
That means you cannot rely on your insurer to cover all your ambulance fees.
In fact, it’s worth discussing this with your insurer before you need to use an ambulance in an emergency, to find out what they will and won’t cover.
Public Ambulances vs. Private Ambulances
It’s worth noting that there are some differences between the types of ambulance services in the United States and this may affect the bill you’re presented with for using their services.
You will find that there’s a mix of private ambulance services (which may or may not be operated for profit) and public services. And that it’s almost a 50-50 chance that you will find a private provider rather than a public one.
Ambulance services, unlike almost all other forms of emergency service in the United States, are much less likely to be government-run.
Now, it’s important to note that this, to some extent, doesn’t matter. Paramedics on all ambulance services are not tasked with bill padding and making a profit.
Their job is to treat you and, if necessary, get you to a hospital for further treatment.
But… in many parts of the country, the sad truth is that for-profit ambulance services are the norm, and they are often used as an upfront payment service to help finance other parts of the operation.
All of this ensures that there’s nothing like a standard charging model in the ambulance industry.
Charges vs. Collections for Ambulance Bills
The public vs private side of things can have a big impact on your bill but something that’s going on under the surface of the entire ambulance industry is going to have a bigger impact.
Your bill for ambulance services isn’t just your bill. The industry has a chronic collections problem. That is, the vast majority of ambulance bills that are sent out are never paid off.
This means that your bill has to contain a chunk to cover those bills too.
How bad is this problem? It’s really bad. Some ambulance services expect to collect as little as 10% of the amounts that they invoice their users.
So, for example, an ambulance service might send out 100 invoices for $1,500 each. They might find that 8 of them are paid in full by the users. Then Medicare and Medicaid might make partial payments on 4 or 5 more. And the rest? Never get paid at all because the individual had no insurance or gave the wrong address to send the bill.
Obviously, this is a huge problem, and it means that ambulance services have to pad their bills. There is a limit on this. After all, if the bill is so huge that nobody can pay it, all the ambulance service can get is what insurers will give them, which is never the full value of the invoice.
So, in a lot of cases, the total collected invoices can still be lower than the value of services provided by that ambulance service.
This video goes into more detail about this problem:
The Complexity Of Billing For Ambulances
Another problem with a multi-tier insurance-driven health service like the one we have here in the United States is that the billing process itself is hugely complicated and involves the worst excesses of government and corporations working together.
Take a few minutes to review the Medicare Fee Schedule, which is a tiny part of the process, and you’ll soon realize that this is over the top.
This means that if you ask a provider of ambulance services to explain their fee breakdown, they often can’t.
The bills are calculated by software that incorporates all these incredibly complex rules and thus, there’s very little chance that a paramedic or office administrator is going to be able to explain the bill to you and if they could?
You probably wouldn’t understand it without a degree in accounting.
As a firefighter/paramedic, I get patients all the time asking how much the ambulance transport is going to cost, and unfortunately, I have no way of giving them a reliable answer. That is just how the system we are in currently works.
There has been a recent push for more pricing transparency in healthcare and hopefully, that will apply to emergency medical services sooner, rather than later.
How Much Does It Cost To Run An Ambulance?
Running an ambulance isn’t cheap.
You need to buy the vehicle, equip it with useful equipment, service and replace that equipment as necessary, fill it with gasoline or diesel, service the vehicle, clean the vehicle, and most of all, you have to staff the vehicle.
In fact, the greatest cost associated with ambulance services is staff wages. Even though EMTs and paramedics aren’t known for having high salaries, it is still the most expensive part of an ambulance operation.
You have to pay an EMT and/or a paramedic a decent wage because you really wouldn’t want them to be paid the same wages as fast-food workers (they’d have no incentive to study or be good at being a medical professional if you did).
How much does it really cost? Well, it depends. The people who run ambulance services work using a formula that measures the utilization of an ambulance.
This, essentially, sees the costs of an ambulance allocated to each hour that it is in use. And this tends to be around $100-$200 an hour. That’s not bad really, it’s less than you might pay for specialist care in a hospital for an hour.
However, it adds up pretty quickly and an ambulance running for 10 hours a day, may need to bring in $2,000 just to cover the costs.
This helps to explain why, combined with the collection’s crisis, ambulance bills are so high. And if the company running the ambulance needs to make a profit too? That has to go on top of that figure.
The Financial Incentives To Use An Ambulance
And then there’s one final ugly truth about ambulances.
Ambulance services are incentivized to declare that you need a trip to a hospital or care facility and then to whisk you away to one.
Why? Well, if a paramedic saves your life on the scene, the ambulance service can bill for this. But most forms of insurance don’t pay out for this, nor does Medicare or Medicaid, and if they send the bill to the user? Well, they won’t pay it either.
This means that in practice, there is no financial compensation for an ambulance service that provides on-site treatment that saves lives!
So, the only way for them to improve the odds of getting paid is to throw you in an ambulance and cart you off to the hospital.
Now, many times, patients will need to be taken to the hospital to get a higher level of care from a doctor. Paramedics and EMTs can do a lot in life and limb-threatening scenarios, but they are still not doctors, and sometimes more equipment and knowledge are needed.
How To Save Money On An Ambulance?
We need to be super clear about this. If you need an ambulance for any reason because you have a genuine medical emergency that needs attention prior to heading to a hospital? Don’t even think about the bill, call 911 and get an ambulance.
There’s no amount of money that will compensate for the death of you or anyone else.
However, if your medical emergency does not require the use of an ambulance. We can recommend that you call an Uber and let them take you to the hospital, instead, this is going to work out much, much cheaper.
In fact, in most cases using Uber is going to be cheaper than the copay on an ambulance ride, even if your insurer will cover the whole cost.
How Much Does An Air Ambulance Cost?
An air ambulance is an ambulance service typically used to transport a patient urgently from one medical facility to another that is too far away to make driving a practical option or at speeds faster than a regular ambulance can handle.
Air ambulances are not cheap. On average they can cost up to $40,000 for a single flight! However, assuming your insurance is good enough, the majority of an air ambulance’s fees will be met by your insurer.
Take a look at this video for more information on air ambulance costs: