WASHINGTON, DC — When you call 911, you’re not thinking about how much a medical emergency could cost you.
“I knew that ambulances could be expensive. I had no idea that they could be this expensive,” said Caroline Fransen.
Fransen said she never used an ambulance until her infant son got sick in 2021. She said he was rushed from a local emergency room to a nearby children’s hospital for specialized care.
The 17-mile ambulance ride led to a $7,075 bill. Fransen said that was on top of nearly $12,000 her family already owed after her son, Isaac, was born prematurely.
“I was, I was scared. I just didn’t know how we’re gonna make those payments. It was a terrible feeling,” said Fransen.
Fransen said her insurance company covered part of the ride and she was able to negotiate with the directly ambulance company to get the remaining balance down to $1,000. But she had to pay that bill the same day.
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In the future, she said she may reconsider whether to call an ambulance during an emergency.
“Because just the thought of having another bill like that it’s scary. But that can happen even with insurance, you know,” said Fransen.
Fransen said her son, Isaac, is now doing much better but her family’s experience with expensive, surprise ambulance bill isn’t unusual.
That’s why consumer advocate Patricia Kelmar said groups are pushing for federal protections for patients.
“When people call 911, they are sent an ambulance, they’re not choosing which ambulance service is responding but about 50 percent of the time that ambulance will not be part of their insurance network,” said Patricia Kelmar with the U.S. Public Interest Research Group.
Kelmar said 18 states, including Ohio, have laws in place to protect patients with insurance from surprise ambulance bills.
She explained those laws allow patients to pay their normal in-network rate whether that ambulance was part of their insurance network or not. Those states have also found creative ways to ensure ambulances can still operate 24/7. Kelmar said some states are using the rate already negotiated by a town with their local ambulance service.
“If x community is paying $1000 for this type of emergency transportation that’s what the insurance company is going to have to pay and so that’s borrowing a state or local community rate that’s already established,” she said.
Kelmar was part of a federal advisory committee that’s now offering recommendations to Congress.
“Making sure the bills are clear and easy to understand and that patients would be able to fight an ambulance surprise bill should it come after a law passes,” she said. “No bills should be sent to a patient until the insurance has already looked at it and paid their portion of it so there are the kind of things we need to do to make sure patients are getting the right information.”
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