The Crazy Economics Of Ambulance Charges

This morning I blogged on our Regency Nursing Website (right over here) regarding the wild west of ambulance charges for transporting patients to and from hospitals.

Just ask Robin Spring. While undergoing chemotherapy for uterine cancer two years ago, she became short of breath and faint at her home in rural Corralitos, Calif. She called her oncologist, who told her to call 911. The ambulance took her to a hospital 20 miles away, where she was admitted with a bowel obstruction. She stayed for 10 days.

The ambulance bill was $2,288. Her insurance policy paid $750 of that total, leaving Spring responsible for the balance of $1,538. When she called her insurer to find out why it hadn’t covered more of the bill, she learned that while her plan covered 80 percent of charges for in-network ambulance services, coverage for an out-of-network provider maxed out at $750. And there was a twist, as she later learned: There were no in-network ambulance services in Santa Cruz County, where she lived.

“It made me furious,” says Spring, now 64. “I thought, ‘This is a real setup.'” She appealed the decision to her plan but was turned down. She then pursued an appeal through the state’s independent medical review process, and the insurer eventually paid the ambulance bill in full.


Leave a Reply