The Sky-High Costs of Air Ambulances Are a National Emergency

It’s out of reach for patients who must fly long distances

Eric was in a near-fatal car accident on May 31, 2022, in Las Vegas, NV. My grandson’s spinal cord was severed and he’s a paraplegic with limited use of his arms.

His mother, myself, and his siblings live in Oklahoma. They have released him from the hospital and he is staying with friends. Eric wants to come back home to receive proper care and to be with his family.

However, when I looked into arranging a flight back home to Tulsa, I was in for a shock. The logistics of air transport are a nightmare, and the cost is as high as the altitude the planes fly!

Just think about that for a moment.

An air ambulance flies at 33,000 feet and that is the median cost for transport! I believe that constitutes a national emergency.

The sky-high costs of air transport

The price of an air ambulance is climbing as high as the plane itself, up to 60% higher from 2012 to 2017. However, much of the cost depends on whether you have insurance. For those who have none, the sky is the limit.

For instance, Medicare patients do not pay the full amount, however, uninsured and out-of-network patients are billed the maximum rate. But the thing is, most patients have no control over whether their providers are in-network or out.

A study in Health Affairs states that 72% of airlifted patients are likely to receive an out-of-network bill. In 2017, a report by the US Government Accountability Office showed that air ambulance companies charge a median price of $40,600 for a plane ride.

But a lot depends on whether a patient qualifies for commercial or private-based companies.

Qualifications for air transport

The state of the patient’s body determines if they fly in a private jet or a commercial airline. If they are ambulatory and can transfer into a seat with no help, they can fly on a commercial airline. A nurse and family member can also accompany them.

However, if a person is paraplegic like my grandson, he has to fly on a small jet that can hold a stretcher. In that case, airline companies arrange all the logistics from a patient’s bed to an airplane.

This is where the cost becomes astronomical. The airlines charge anything they want because the government deregulated the entire airline industry in 1978.

The purpose of the Airline Deregulation Act was to encourage competition among the airlines and drive down airfares. However, the 1978 law makes no provision about how air ambulances should be treated.

The prices are not competitive either. I requested quotes from several air ambulance companies for my grandson. One quote was $9,000, and the other was $22,300.

Because Eric was already released from the hospital, the airline company told me Medicare wouldn’t pay for the flight. What do I do? Drive from Las Vegas, lay Eric in the backseat, and hope he doesn’t have a medical emergency.

So I started a GoFundMe page. But it’s nowhere in the range we need.

Beyond my grandson, I wonder what can the government do about this national emergency.

Solutions

According to a report in the NIH:

“Surprise billing by air ambulances is a national public emergency that must be remedied through comprehensive Congressional action.”

Finally, Congress passed legislation to ease the burden of surprise billing. However, it still doesn’t help with regulating the air ambulance industry.

Starting on January 1, 2022, the No Surprises Act1 (NSA) protects uninsured (or self-pay) individuals from many unexpectedly high medical bills. The Act requires that health care providers and facilities give uninsured (or self-pay) individuals an estimate for the cost of their health care before the individual agrees to get the item or service. Throughout this document the term “providers” also includes providers of air ambulance services.

But what about the uninsured? Not everyone in America is insured, even with the Affordable Care Act (ACA). For instance, if the patient’s state hasn’t adopted Medicaid expansion under the ACA, they may not have insurance.

Again, what do we do? The air ambulance fares are out of reach. We need action now! I’m not sure what the answer is other than depending on the charity of others.

But together, maybe, just maybe, we can figure this thing out.

Debbie Walker is a great-grandmother, writer, blogger, and the creator of Middle-Pause & Forward Motion, the podcast STOMP!, MPM Publishing, and has published three of a four-book anthology of Middle-Pause writers. Stay in touch at [email protected]; follow her on Facebook; Twitter; Pinterest; & listen to STOMP!