Frequently Asked Questions
OVERVIEW AND MEMBERSHIP BENEFITS
How did the Air Evac Lifeteam membership program get started?
Air Evac Lifeteam was one of the first air ambulance services to offer a membership program, similar to the ground ambulance and rural fire department programs throughout the United States. The founders knew that for the service to survive in a rural area, they would need other sources of funding besides the traditional fee-for-service billing. They discovered the REGA (pronounced Reega) Foundation in Switzerland, which supports a nationwide air ambulance system by a membership program. After meeting with the head of REGA, Air Evac Lifeteam adopted this idea.
What is the benefit of membership to you?
Although you do not have to be a member to be transported, membership offers several important benefits:
First, as one of more than 1 million members, Air Evac Lifeteam will work on your behalf with your benefits provider to secure payment for your flight, with any uncovered amounts considered to be fully prepaid. As such, members who are transported by Air Evac Lifeteam will not receive a bill for the flight. Importantly, your membership is valid in all of our service areas so you are covered while traveling in those areas.
Second, becoming an Air Evac Lifeteam member is a good way to support the health care needs of your local community. Our membership base - the largest of its kind in the United States - helps us operate in rural areas where having a quick response time to critical medical situations can save lives. Approximately 90% of our patient transports originate from a super rural or rural zip code as defined by the Centers for Medicare & Medicaid Services (CMS). If it weren't for our members, we would be challenged to provide this lifesaving service in many of these outlying communities.
How can a membership be so inexpensive and yet still be able to cover the costs of the flights?
An individual's membership fee covers only a small fraction of the cost of a flight. Our membership support helps subsidize our program, but our primary revenue is derived from our transports, the vast majority of which are non-members; only a fraction of the patients we fly are Air Evac Lifeteam members.
What is included in my membership?
Members are entitled to transport by an available Air Evac Lifeteam helicopter to the closest appropriate medical facility for medical conditions deemed by an attending medical professional to be life- or limb-threatening, or that could lead to permanent disability.
Can I cover all of my family on the membership?
With an Air Evac Lifeteam household membership, all individuals who reside at your residence can be covered by the membership. College students can be covered by the household membership if their primary address is the same as your residence.
Is there a limit to the number of flights a member can have in a year?
There is no limit to the number of flights a member may take in a year. Each flight is handled the same way and must be medically necessary.
If I am a member and end up being transported by a ground ambulance or another air ambulance service, who is responsible for the bill?
If Air Evac Lifeteam does not transport you, you will be responsible for payment of the bill. Our membership program only covers flights by our service.
PREPAID PROTECTION FOR MEMBERS
Is an Air Evac Lifeteam membership considered insurance?
No. Air Evac Lifeteam is not an insurance company. An Air Evac Lifeteam membership is not an insurance policy and cannot be considered as secondary insurance coverage or as supplemental coverage to any insurance policy. Membership provides prepaid protection against covered Air Evac Lifeteam air ambulance transportation costs that exceed a member's health insurance or medical benefits.
Does my primary insurance cover the cost of a flight? If so, how much?
This answer varies, with each insurance company offering different plans and coverage. It is up to your individual insurance company as to whether they will cover the cost of a flight, as well as to the amount of economic burden placed on the patent via a co-pay or deductible. We recommend that you contact your insurance company directly to obtain detailed coverage information.
My insurance company says they will cover 100% so why do I need this membership?
Most insurance companies will pay 100% of what they deem an allowable amount for air ambulance, which does not necessarily mean that the total cost of the flight will be covered. Additionally, people frequently change insurance companies and plan designs. You will want to check with your individual insurance company to find out exactly how much they will cover in the case of an air ambulance transport.
If I have Medicaid, do I need a membership?
No. Some state laws prohibit Medicaid beneficiaries from being offered membership or accepted into membership programs. As part of our application process, members certify to Air Evac Lifeteam that they are not Medicaid beneficiaries, with Air Evac Lifeteam accepting Medicaid as full payment for services rendered.
If I have Medicare and a supplemental policy, do I need a membership?
The answer varies, depending upon the nature of your transport and your supplemental insurance provider. In many cases, Medicare and the supplemental insurance coverage should pay for the cost of air ambulance transport if it is medically necessary and if Medicare believes you were taken to the closest appropriate hospital. However, we have seen cases where the supplemental insurance provider does not cover a remaining balance after Medicare has paid its portion. Many seniors have said they want a membership even if they have complete coverage, in the event that their insurance coverage changes in the future or if the claim is denied.
PROVISION OF SERVICES
If I have a medical emergency, should I call the Air Evac Lifeteam Operations Center emergency line or the local 911 service?
Call your local 911 service. The 911 dispatchers are trained to get specific information about the medical emergency from the caller and determine what type of medical transportation best fits the situation, so the best option is to always call the local 911 service first. The local service is more familiar with your location, as well as the availability of the local emergency resources. They may have information to aid you that the Air Evac Lifeteam Operations Center may not be aware of.
How would emergency personnel know that I am an Air Evac member?
You may make the 911/ground ambulance service aware that you are an Air Evac Lifeteam member so that in the event they plan to request an air ambulance, they know your preference is for Air Evac Lifeteam. As a member of Air Evac Lifeteam, you will receive with your membership an identification card and stickers for your vehicle and front door. All of these items allow emergency personnel to identify that you are an Air Evac Lifeteam member.
Who determines if and when I will be flown?
If your medical emergency meets certain criteria, such as a heart attack, stroke or a traumatic injury and the 911 dispatcher determines you would benefit from air medical transport, they will dispatch an air ambulance to your emergency, as well as a ground ambulance. Hospital-to-hospital transfers are ordered by physicians. In the event that the Air Evac Lifeteam Operations Center receives a call for emergency help from an individual or source other than a healthcare or emergency services agency, Air Evac Lifeteam communication specialists will identify and contact the ground EMS service in the patient's community and ask them to respond to the scene. If they determine air medical transport is needed, they will dispatch one of our helicopters.
Does a membership ensure that Air Evac Lifeteam will fly me, no matter what type of medical care I need?
Air ambulances are valuable and scarce resources that should be reserved for those times when a patient is facing a critical injury and we believe it is in their best interest to get to medical care at a rapid rate. Air Evac Lifeteam will not transport patients by air if air transportation is not believed to be medically necessary.
Who decides where to fly the patients?
When a helicopter is called, time is of the essence. Patients in life threatening situations often need specialty centers to provide the interventions needed. Air Evac Lifeteam will take a patient to the closest appropriate medical facility. Whenever possible, physicians or EMS personnel consult with the patient or the patient's families as these decisions are being made.
Will a helicopter always be available if I need one?
There may be times when the helicopter in your area is committed on another patient flight or is out of services for maintenance or weather-related issues. In those instances, we may be able to call one of our other Air Evac helicopters from an adjoining service area. In some cases, however, you may need to be transported by a ground ambulance or another air ambulance services. It is important that you get to the medical care you need as quickly as possible, no matter what the mode of transportation, so you will have the best chances for survival and degree of recovery.
Are there other reasons why an Air Evac Lifeteam helicopter might not be able to fly me?
The primary determinant of whether to accept a flight is always the safety of the patient and our medical flight crews. Federal Aviation Administration restrictions prohibit Air Evac Lifeteam from transporting patients under certain conditions, such as flying in inclement weather or when weight limits are exceeded; accordingly, we don't transport patients weighing more than 400 pounds.
COLLABORATION WITH OTHER HEALTHCARE PROVIDERS
What role does Air Evac Lifeteam play in the emergency services community?
Our crews work closely with ground ambulance services and other EMS agencies in our service areas. We recognize that good patient care requires a team effort of everyone involved - from first responders and law enforcement officials to ground ambulance and hospital personnel. We all play separate, but very important roles, in getting the patient to the appropriate medical care. We do not want to replace any emergency service already in place in a community. Our role is to be a resource they can call on when a higher level of care or special mode of transportation is needed.
Does Air Evac Lifeteam work with local ambulances?
Yes. Air Evac Lifeteam works very closely with ground EMS agencies. These agencies request Air Evac Lifeteam to transport their patients when medically necessary. Air Evac Lifeteam also provides appropriate training and education for ground EMS agencies.
Is there a special discount for EMS/Fire/Police people?
No. Air Evac Lifeteam is strongly committed to complying with all applicable healthcare regulatory guidelines, as well as all rules and regulations governing its participation in both Medicare and state Medicaid programs. In order to avoid even the appearance on non-compliance with applicable healthcare regulatory guidelines, Air Evac Lifeteam does not offer discounted memberships to people just because they are healthcare or emergency personnel, given that such special discounts to healthcare or emergency personnel might be viewed as an attempt to influence referrals.
Can other unaffiliated air medical providers honor Air Evac Lifeteam memberships?
For other unaffiliated air medical providers, we do not believe so. Federal law prohibits the routine waiver of co-pays for services covered by Medicare or Medicaid. However, through an ambulance membership program, membership fees are collected in lieu of the collection of co-pays ("co-pays" is used to refer to all types of patient cost-sharing amounts, including co-payments and deductibles). OIG guidance provides that where membership fees collected from members (or members who are Medicare beneficiaries) "reasonably approximate" the amounts that these individuals would expect to spend for cost-sharing amounts over the period covered by the membership agreement, there is, essentially, no impermissible waiver of co-pays. Therefore, where a specific air ambulance supplier (such as Air Evac Lifeteam) operates a membership program and does not bill its members for co-pays associated with its air transport services, this would not be considered to be a prohibited waiver of the co-pays (i.e., the billing and collection of the membership fee would negate any obligation of the specific air ambulance supplier to bill the patient for the co-pay). This analysis does not hold true, however, if a separate, unaffiliated supplier of air transport services (such as an unaffiliated competitor to Air Evac Lifeteam) waives a co-pay for services provided to an Air Evac Lifeteam member. In this case, the competitor has not collected any membership fees from the Air Evac Lifeteam member, because these fees have only been collected by Air Evac Lifeteam. As a result, the competitor has not collected any funds from the patient that would justify refraining from billing the Air Evac Lifeteam member for the co-pay. In summary, if a competitor provides services to an Air Evac Lifeteam member, the competitor is obligated to collect a co-pay from that individual (unless, of course, the Air Evac Lifeteam member is also a member of a qualifying membership program operated by the competitor).
Will Air Evac Lifeteam honor other unaffiliated air medical provider memberships?
No, for the reasons described above. While Air Evac Lifeteam appreciates operating under a team-oriented approach to provide the highest levels of patient care and service in the regions it serves, it is strongly committed to complying with all applicable healthcare regulatory guidelines, as well as all rules and regulations governing its participation in both Medicare and state Medicaid programs, and therefore cannot honor other unaffiliated air medical provider memberships.
TERMS & CONDITIONS AND ENROLLMENT
What are the terms and conditions of membership?
An Air Evac EMS, Inc. d/b/a Air Evac Lifeteam ("Company") membership ensures the patient will have no out-of-pocket flight expenses if flown by the Company or another AirMedCare Network participating provider (together with the Company, each an "AMCN Provider") by providing prepaid protection against AMCN Provider air ambulance costs that are not covered by a member's insurance or other benefits or third party responsibility, subject to the following terms and conditions:
1. Patient transport will be to the closest appropriate medical facility for medical conditions that are deemed by AMCN Provider attending medical professionals to be life- or limb-threatening, or that could lead to permanent disability, and which require emergency air ambulance transport. A patient's medical condition, not membership status, will dictate whether or not air transportation is appropriate and required. Under all circumstances, an AMCN Provider retains the sole right and responsibility to determine whether or not a patient is flown.
2. AMCN Provider air ambulance services may not be available when requested due to factors beyond its control, such as use of the appropriate aircraft by another patient or other circumstances governed by operational requirements or restrictions including, but not limited to, equipment manufacturer limitations, governmental regulations, maintenance requirements, patient condition, age or size, or weather conditions. FAA restrictions prohibit most AMCN Provider aircraft from flying in inclement weather conditions. The primary determinant of whether to accept a flight is always the safety of the patient and medical flight crews.
3. Members who have insurance or other benefits, or third party responsibility claims, that cover the cost of ambulance services are financially liable for the cost of AMCN Provider services up to the limit of any such available coverage. In return for payment of the membership fee, the AMCN Provider will consider its air ambulance costs that are not covered by any insurance, benefits or third party responsibility available to the member to have been fully prepaid. The AMCN Provider reserves the right to bill directly any appropriate insurance, benefits provider or third party for services rendered, and members authorize their insurers, benefits providers and responsible third parties to pay any covered amounts directly to the AMCN Provider. Members agree to remit to the AMCN Provider any payment received from insurance or benefit providers or any third party for air medical services provided by the AMCN Provider, not to exceed regular charges. Neither the Company nor AirMedCare Network is an insurance company. Membership is not an insurance policy and cannot be considered as a secondary insurance coverage or a supplement to any insurance coverage. Neither the Company nor AirMedCare Network will be responsible for payment for services provided by another ambulance service.
4. Membership starts 15 days after the Company receives a complete application with full payment; however, the waiting period will be waived for unforeseen events occurring during such time. Members must be natural persons. Memberships are non-refundable and non-transferable.
5. Some state laws prohibit Medicaid beneficiaries from being offered membership or being accepted into membership programs. By applying, members certify to the Company that they are not Medicaid beneficiaries.
6. These terms and conditions supersede all previous terms and conditions between a member and the Company or AirMedCare Network, including any other writings, or verbal representations, relating to the terms and conditions of membership.
*** The preceding Terms and Conditions apply to all AirMedCare Network Providers. Emergent ground ambulance transport of a member by an AMCN Provider will be covered under the same terms and conditions.
How do I enroll?
You can enroll by calling toll-free 800-793-0010 or go to our online enrollment. You may also enroll by contacting your local membership coordinator.
When does my membership take effect?
Membership starts 15 days after Air Evac Lifeteam receives a complete application with full payment; however the waiting period will be waived for unforeseen events occurring during such time.
Information/Data as of June 2012