Different kinds of insurance coverage for ambulance services:
- The insurance company will provide ambulance coverage on the only name on the membership card. This is called as the single coverage insurance.
- The insurance company will cover for the name in the membership card including the spouse and the minor children of the member. This is called the family coverage insurance.
The member of the insurance can get the benefit if there is an accident, emergency cases, your ambulance coverage will be free one day after you join or there is also coverage for the ambulance after a month of joining.
Insurers have different kinds of policy, make sure that you r4ead the contract carefully and know the coverage if that is fit for your needs. If not you can still look for an insurance company that may cover for what you need. Read carefully the coverage and study carefully the content of the insurance. Depending on your insurance company, the mode of transportation (ground, helicopter, jet), medical necessity, co-pay and deductible will determine what the patient actually pays for air or ground ambulance services.
“These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.
- Fixed Wing Air Ambulance for hospital to hospital transfers, including air transportation to return to the network requires prior authorization via HealthPartners Disease & Case Management Department.
- All other transportation services do not require prior authorization.
Ambulance and medical transportation is covered for medical emergencies and as per the indications listed below.
Indications that are covered
- Emergent situations.
- Medical emergency situations.
- Transfers between hospitals for treatment by network physicians are covered, if initiated by a network physician.
- Transfers from a hospital or at home to other facilities are covered, if medical supervision is required en route.
- Emergency Air Transportation (helicopter): Emergency transportation by air ambulance is covered if the member has a potentially life-threatening condition that does not permit the member to use another form of transportation. OOA (Out of Area) emergency admission transportation is covered when the member needs primary or secondary transportation to the nearest facility qualified to treat the medical emergency.
- Fixed Wing Air hospital to hospital transfer (including transportation back into network from out of area) must have prior authorization from the case management department. See “Note” under Administrative Process for phone numbers and direction.
- Medically necessary emergency medical care provided by an ambulance service when the member is not transported to a hospital.
- Care provided by first responders. Examples include, but are not limited to, a rural area where the fire department arrives first and stabilizes the patient’s condition. The patient may then be taken to the Emergency Room (ER) by a family member or an ambulance once the patient is stable enough for transport. The care given by the fire department would be covered.
Indications that are not covered
- Non-emergent situations.
- Transfers from home or a covered SNF (skilled nursing facility) to a physician’s office or other facilities for outpatient treatment, procedures or tests.
- Transportation which does not require medical supervision en route.
Indications – other
- Service must be provided by a HealthPartners contracted vendor.
For members using out of network (OON) or out of area (OOA) medical transportation, see “Note” under
Read the entire post and definitions at https://www.healthpartners.com/public/coverage-criteria/ambulance-medical-transportation/
Remember that every policy will have its coverage and limitation. Make sure that you read carefully the coverage of your insurance with regards to ambulances. Also, depending on the insurance policy there will also some limitation on the amount they will pay for your medical expenses. Some of the insurance coverage may include the ground ambulance, but not the air ambulance. Some insurance policy can cover for the air ambulance only if the requirements are met. Coverage will be different in every plan. So as an individual that wanted to have an insurance coverage, make sure that you know what your contract say’s and if that coverage will be best for your future needs. Remember that health care can be very expensive.
What About Canada Insurance in the US?
“ We all know and understand that our Canadian Health Insurance Program is not available outside of Canada, at least not to the levels that we have come to expect. In fact, these days only about 10% of a person’s out of country medical costs will be covered by their Provincial Health Insurance.
We have all come to realize that when travelling it is imperative to purchase additional travel insurance coverage to look after us in the event of an accident or emergency medical situation. The problem is that travel insurance can be expensive, confusing and downright difficult. As we get older the insurance rates typically increase and heaven forbid there is an ongoing medical situation or a pre-existing condition because then it just goes downhill from there.
More and more often I hear of people that are frustrated with their insurance options (or lack of them) suggest that perhaps they will forego travel insurance this year and just buy into an Air Ambulance Evacuation plan. It is less expensive and will bring them home in the event a problem occurs and they won’t get stuck racking up hospital bills in the USA or overseas. Right?
These conversations scare me. Don’t get me wrong Air Ambulance plans are great, cheap and fairly easy to purchase. They are a good idea for the adventure seekers who might find themselves stranded on the side of a mountain. It is also an option for folks that don’t have additional health insurance or employee plans (these plans will typically cover air ambulance costs in Canada for covered situations).
They are NOT however a substitute for Emergency Medical/Travel insurance.
What people need to understand is that if you have a heart attack or an involved in a serious car accident in Arizona or Hawaii this winter you won’t just get put on an aircraft and flown home. The trauma physician in charge of your case has to confirm that you are STABLE and then release you. In addition to the stability requirement the doctor has to know that there is a bed for you at the other end or they will not sign the release. You could end up in a U.S. hospital for several days or longer until the attending physician is satisfied that it is safe to release you. It is their professional responsibility and their job on the line to ensure it is medically safe for you to travel.
I recommend that you carefully discuss your travel insurance plans with a CAA Consultant before making a final decision. CAA Insurance and Travel experts can review your insurance options with you to make sure that you are fully protected in the event of a health situation and answer all your questions about insurance.
You don’t want to risk your financial future or your health, so take the time to pack the right insurance.”
There are certain requirements for the insurance company to pay for your air ambulance expenses and here are some of the requirements:
- The insurance company will only cover for the air ambulance cost if the patient’s life is in danger, that ground transport will not be fast enough to transport the patient.
- The Air ambulance cost will also be covered by the insurance policy if there is no way that a ground ambulance can get to where you are.
- Distance will also be one of the considerations that the air ambulance can be covered by your health insurance.
- If the patient is in the rural area and the physician recommends for a medical flight due to the location of the patient, it will be impossible for the ground ambulance to get the patient in the health care facility in time.
When it comes to air ambulance of any sort, you will want to also check with your insurance provider to make sure they are going to cover the transport. In many cases when it comes to a non-emergency air medical transport, a company like Angel MedFlight AirAmbulance will attempt to obtain a pre-authorization for you from your insurance company. In other cases where it is an emergency and you are utilizing a first responder helicopter for your transport, they do not check if your insurance company is covering the air medical evac. Read more about emergency air lift services and insurance here.