How to talk about coverage
Many people may assume that monthly health insurance will cover ambulance rides and other emergency transportation. Unfortunately, this is not always the case. Even with health insurance, you may be exposed to unexpected out-of-pocket expenses and the increasingly high costs of emergency transportation.
Out-of-network providers
There are over 27,000 ambulance companies operating in the United States and many health insurance plans may only cover a limited amount of in-network providers. The truth is, there’s no guarantee that participants will get picked up by an in-network provider. According to Consumer Reports, 79% of all ground ambulance rides could result in an out-of-network bill. Essentially, that means there is an almost 80% chance of being left responsible for a majority of the bill.
MASA plans cover all emergency transportation providers within the continental United States and while traveling in Canada, so there is never a need to worry about which ambulance company is called.
Insurance will judge the reason for your trip
As insurance professionals, we know that insurance may only pay for an ambulance if a trip is deemed “Medically Necessary.” As a quick refresher, let’s remember that medical necessity is established when any other transportation method (besides an ambulance) would endanger the patient’s life.
Let’s say symptoms commonly associated with a heart attack prompt an emergency call that results in an ambulance ride to the hospital. If the health insurance decides the cause of the symptoms (perhaps indigestion, heartburn, or a panic attack) doesn’t meet their requirements for an ambulance, they could deny the claim and potentially leave you with thousands of dollars as out-of-pocket costs.
Insurance only pays the Usual, Customary and Reasonable Rate
If you are picked up by an in-network ambulance and the claim is accepted by the insurance, the carrier only pays the Usual, Customary, and Reasonable Rate.
Responsible for copays and deductibles
Even if bills fall within the Usual, Customary, and Reasonable Rate, we know most insurance plans require the individual to cover copays and deductibles.
Depending on the plan, with deductibles as high as $8,000 and regardless of other variables, employee participants may automatically be on the hook for hundreds to thousands of dollars to fulfill an insurance plan’s requirements. MASA will take care of out-of-pocket expenses, including copays and deductibles resulting from emergency transportation bills.
Sources:
IBIS World, Ambulance Services Industry in the US – Market Research Report
Consumer Reports, Your Ambulance Ride Could Still Leave You With a Surprise Medical Bill
According to CNBC, two-thirds of people who file for bankruptcy cite medical issues as a key contributor to their financial downfall. The same article claims that “what most people don’t realize is that their health insurance may not be enough to protect them.” It’s estimated that 530,000 families turn to bankruptcy each year because of medical issues and bills.
Think of MASA like a financial safety net. Our low, monthly fee is designed to save thousands of dollars in the event of an accident or emergency.
530,000 PEOPLE TURN TO BANKRUPTCY
EVERY YEAR due to medical issues & bills.
Sources:
MetLife
CNBC, This is the real reason most Americans file for bankruptcy
A recent report from Federal Reserve found that only 40% of Americans have enough savings set aside to cover a $400 emergency expense. The average charge of a ground ambulance is well over $1,500.
Not everyone can set aside thousands for medical emergencies. Most people don’t even plan for them at all. That’s just one of many reasons why affordable monthly coverage is a great way to protect employees and their families. Even with established considerable savings, a single emergency may drain an account and negate years of hard work. The truth is, everyone can benefit from having emergency transportation coverage. Complete peace of mind is worth the cost alone, but when considering the added financial protection, it’s a no brainer.
Sources:
Federal Reserve, Report on the Economic Well-Being of U.S. Households in 2018 – May 2019
HealthCareInsider, Why Ambulances Are So Expensive
Since 2010, many health insurance plans have provided insufficient coverage when it comes to emergency transportation. Even the best insurance companies may only cover a limited-amount of in-network providers. Unfortunately, there’s no guarantee an in-network ambulance will be called to provide care and delivery to a medical facility.
MASA works alongside modern health insurance, providing financial protection if the employee or a dependent family member needs emergency transportation.
When emergencies happen, the last thing you want to worry about is whether or not the ambulance is in-network. In most cases, there is no control over who renders services.
MASA covers all ground and air ambulance providers within the continental United States and while traveling in Canada. As MASA members, there’s never a need to worry about which ambulance company picks you up.
With MASA, the employee Member can feel confident when an emergency strikes that they won’t have to worry about out-of-pocket expenses that may result from the emergency transportation.
Employers can choose from a variety of methods for addressing the cost of coverage, including:
- Employer paid
- Cost share at any level
- 100% employee paid via payroll deduction