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Without Medicare Part B's shield, patient's family owes $81,000 for a single air-ambulance flight

Tony Leys, KFF Health News on

Published in Health & Fitness

Debra Prichard was a retired factory worker who was careful with her money, including what she spent on medical care, said her daughter, Alicia Wieberg. “She was the kind of person who didn’t go to the doctor for anything.”

That ended last year, when the rural Tennessee resident suffered a devastating stroke and several aneurysms. She twice was rushed from her local hospital to Vanderbilt University Medical Center in Nashville, 79 miles away, where she was treated by brain specialists. She died Oct. 31 at age 70.

One of Prichard’s trips to the Nashville hospital was via helicopter ambulance. Wieberg said she had heard such flights could be pricey, but she didn’t realize how extraordinary the charge would be — or how her mother’s skimping on Medicare coverage could leave the family on the hook.

Then the bill came.

The Patient: Debra Prichard, who had Medicare Part A insurance before she died.

Medical Service: An air-ambulance flight to Vanderbilt University Medical Center.

 

Service Provider: Med-Trans Corp., a medical transportation service that is part of Global Medical Response, an industry giant backed by private equity investors. The larger company operates in all 50 states and says it has a total of 498 helicopters and airplanes.

Total Bill: $81,739.40, none of which was covered by insurance.

What Gives: Sky-high bills from air-ambulance providers have sparked complaints and federal action in recent years.

For patients with private insurance coverage, the No Surprises Act, which went into effect in 2022, bars air-ambulance companies from billing people more than they would pay if the service were considered “in-network” with their health insurers. For patients with public coverage, such as Medicare or Medicaid, the government sets payment rates at much lower levels than the companies charge.

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©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

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