Kentucky lawmakers are considering new regulations to require health insurers to pay for air ambulance services, even for providers that are out of insurers’ coverage network.
Getting transported to a hospital by helicopter is expensive, especially without help from a health insurance company.
Brad Salyer, a bankruptcy attorney from Bowling Green, said he received a $57,000 bill after his infant son had to be flown from a local hospital to Nashville in order to receive advanced emergency treatment.
“The doctor told us it was absolutely necessary that he maintain that high-flow oxygen and get to Vanderbilt or else they would have to intubate him and keep him there at the hospital,” Salyer told Kentucky’s Interim Joint Committee On Banking And Insurance.
Salyer said that weeks later, his health insurance company Anthem said that because the air ambulance company they used to transport his son was out of network, they would only pay about $10,000 of the bill.
Salyer appealed to both Anthem and Air Methods, the air ambulance, and both companies placed the blame on the other.
“Neither really seems to be acting on behalf of us as an insured or as a consumer. Rather, one side’s trying to limit how much they have to pay and the other side’s trying to maximize how much can recover,” Salyer said.
Sen. Morgan McGarvey, a Democrat from Louisville, said he’s going to propose a bill in the upcoming legislative session that would require insurers to pay for air ambulance transportation, even for out of network companies.
“Very few people in Kentucky have $50,000 sitting in a bank account that they can pay after the fact to save their child,” McGarvey said. “And when that happens you’re contacted and they can come after you and they will.”
Insurers would have to pay out-of-network air ambulance companies an average of how much they pay in-network providers.
Lawrence Ford with Anthem Blue Cross and Blue Shield said that air ambulance services are a “tremendous expense and burden” for the company, but they’ve been working to improve the situation.
“We’re not talking 54 cents per mile, we’re talking about $70 a mile, we’re talking over $9,500 per liftoff plus $70 per mile,” Ford said. “You have my word that we will continue to fight for our members so that they are not put in a situation as described earlier.”
According to a Government Accountability Office report from last summer, people who end up using air ambulances are often unaware of how much they’ll have to pay for transport.
The GAO recommended that air ambulance companies disclose their pricing to consumers.