Does Insurance Cover Air Ambulance Service? Part 2 - Medical Insurance
At least once a week we get a call from a patient or family member and the first question they ask is, “Will my health insurance policy cover medical transport?” Unfortunately, the best answer we can give at that moment is: “It depends.”
On what? Whether or not your medical insurance will cover an air ambulance depends on a number of factors:
- First and foremost, on your policy. Does it specify coverage for air medical transport?
- Does the insurance company deem the transport medically necessary? This is where it can get really sticky. Unfortunately, even if your doctor writes a letter saying that the air ambulance transporting you from facility A to facility B is medically necessary, it is almost always up to the medical director at the insurance company to deem medical necessity.
- Why do you need medical transport? If it’s to get a life-saving procedure that is only performed at a hospital 1,000 miles away from you, then your chances of insurance coverage are certainly higher than if you simply like the doctors at that hospital. But even when a patient needs to get back home – to be with family, for example – the insurance company may not deem the transport medically necessary.
- Is there a closer facility that can provide the same service? If you really want the life-saving procedure performed at the hospital 1,000 miles away, but the hospital 50 miles away can perform the same life-saving procedure, your insurance company is less likely to pay your transport to the hospital that’s farther away.
- Where are you? Sometimes, healthcare coverage does not extend overseas. Medicare, for example, does not provide coverage for hospital or medical costs outside the United States (and actually, Medicare coverage for medical transport in the U.S. is not great either).
If you’re travelling abroad, check with your insurance company to see if (and what) it will cover where you’re going. If the coverage isn’t comprehensive, look into travel medical insurance (which will often include a provision for medical evacuation back home).
Whatever your circumstance, we will absolutely work with your insurance company to try and get them to cover the transport. But unfortunately, until we find out from you about your situation and talk to your insurance company about your benefits, there’s simply no way to say for certain whether insurance will cover the transport.
A number of our patients have been “snowbirds” – people who spend the winter in a warmer location and the summer “back home” with family. In a number of cases, the patient came to Phoenix for the winter and something happened – a stroke, a heart attack, a bad fall. The patient needed to get back home close to family who could help them recover. In many of those cases, health insurance wouldn’t cover the transport (they say it’s not medically necessary, but rather “for the convenience of the family”).
For people who live part-time away from home and family, then, it can make good sense to have a medical transport policy like the ones provided by Medjet Assist (who we’ve worked with before). Though typically less restrictive than regular travel insurance or even medical insurance, these policies still have their fine print – so it’s important to understand what’s covered (and not covered) before you buy a policy.
We can feel about insurance coverage (or lack thereof) how we want (like how ridiculous a denial of coverage feels in the face of all the evidence that being with loved ones speeds medical recovery) but the fact is that health insurance companies will make the decision they make regardless of how we feel about it. So, take the precautions you can take (like getting travel medical insurance) and rely on a trusted medical transport provider to help you work with your insurance company.