How an ambulance ride to the hospital can break the bank 

An ambulance ride to the emergency room is unpredictable and frightening, and the cost is no different. 

Unexpected bills are common in emergency situations, affecting an estimated 20 percent of inpatient emergency visits and 14 percent of outpatient emergency trips in 2014, according to a recent study. 

The Government Accountability Office estimated that ambulance rides in the US costed anywhere between $224 and $2,204 in 2012. 

An ambulance is an expensive vehicle in its own right, but the charges rack up in large part due to a lack of regulation of emergency medical transport services. 

An ambulance ride to the hospital may save your life, but cost you an arm and a leg. The costs and billing criteria for emergency transportation vary widely and are often unpredictable (file image)

Private companies make up 18 percent of US ambulance services, and hospital specific services account for another seven percent, according to the National Association of Emergency Medical Technicians. 

There is no way of knowing before stepping or being carried onto one of these vehicles if it will be covered by your insurance, until you get the bill. 

In New York, the government does regulate the fees charged by fire department ambulances. 

The base rate for a basic life support on an ambulance in New York is $704, but that number keeps creeping up for ‘Level 1’ life support ($1,190) and ‘Level 2’ Life support ($1,290). 

That does not include the $12.00 per mile charge applied for the travel distance between the pick-up point and the hospital. If you need oxygen, it will cost you another $60.00 to breath. 

Medicare and most private insurers cover ambulance rides, but that protection is subject to exceptions.  

If you call 911, the emergency dispatcher must calculate the best responder based mostly on proximity, and will not know which of 14,000 ambulance services in the US is covered by your insurance.

If an insurance provider determines that you asked to be taken to a hospital or other emergency care facility that was not the closest one to where you were picked up, they can leave the transport bill to you.

Insurers can also deny coverage if they determine that you were moved from one hospital to another unnecessarily, or if you did not need to be transported by an ambulance in the first place.  

Though the criteria for any of these varies between insurers, there are a few rules of thumb that are worth following.

Emergency transportation will be covered if you are in severe pain, bleeding or in a state of shock or unconsciousness. Any time you need skilled medical treatment immediate, this will be covered, though some states, like New York, may have an additional charge for oxygen, if you should need it. 

Insurance companies may charge you a percentage of the cost of the ambulance if they believe that you took the ride unnecessarily.  

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