When a Columbus man was flown to IU Health Methodist Hospital after being struck by a car, the last thing on his mother’s mind was the cost of the helicopter flight.
“I didn’t think twice about it,” Christine Taylor said regarding the late-December accident that put her 28-year-old son, Benjamin Taylor, in an Indianapolis neuro intensive care unit. “You don’t put a value on life.”
Nevertheless, several complaints have been made by air-ambulance patients burdened with hefty bills, according to the Indiana Department of Insurance.
Some Hoosiers are being caught off-guard after being instructed to shell out tens of thousands of dollars in out-of-pocket expenses, according to the department’s recent statewide consumer alert.
Although it is something most people rarely check until it’s needed, industry experts are urging Hoosiers to check individual health insurance plans to see if coverage regarding air ambulance service is adequate — especially since patients and their families are seldom consulted prior to the emergency flight.
Central Indiana residents who have health insurance coverage through a reputable provider are likely to avoid huge out-of-pocket expenses for a medical helicopter, compared to other areas of the state or country.
In its alert, the Indiana Department of Insurance specifically refers to the coverage gap between what some private, for-profit air-ambulance firms bill and what insurance companies are willing to pay.
There are two other categories of air ambulance services, however:
Hospital-based services that are a part of the contracts those facilities negotiate with insurance companies and providers.
Nonprofit operators that are affiliated with hospitals.
The LifeLine helicopter stationed outside Columbus Regional Hospital, which serves a sizable part of south central Indiana, is part of the non-profit Indiana University Health network that includes Methodist Hospital in Indianapolis.
PLAYING NEGOTIATOR
IU Health negotiates with most major health insurers in Bartholomew County that consider LifeLine an “in-network” service, so huge coverage gaps seldom occur in the Columbus area, said Greg Fox, a Columbus insurance broker and consultant.Local insurance agents and administrators have not received directives to change long-established policies for air ambulance service, Fox said.“It’s just another line item in everyone’s plan,” said Fox, who only recalls one incident several years ago where a flight from Jennings County to Columbus Regional Hospital resulted in a $2,000 out-of-pocket charge to a family.
In almost every other case, the insurer covers the cost once the premiums and deductible are met, just as it would cover a surgery or other medical procedure, Fox said. In addition, the in-house connection between the network and Methodist Hospital also helps keep the patient’s cost down.
“When hospitals negotiate with insurance, air ambulance is just a piece of the puzzle, and they can make up for deficiencies in other departments,” said Ron Walter, director of business relations and development for REACH Air Medical Services, a California-based company that provides air transportation services in several states.
Besides using financial resources from IU Health, LifeLine also receives funding from philanthropic organizations to reduce patient costs and train personnel, IU Health spokesman Gene Ford said.
But if any medical helicopter is chartered for convenience, rather than deemed medically essential, the amount covered by insurance will drop substantially — even if it’s in-network, personal insurance expert Mila Aravjo said.
Explaining that each charge varies, based on a flat fee and mileage, IU Health officials could not provide an average cost per flight between Columbus and Indianapolis.
But based on figures released by similar organizations, a number of industry sources in Indiana estimate the average total bill handed over to insurers at less than $10,000. But even if you don’t have medical insurance, that doesn’t necessarily mean you are out of luck.
Benjamin Taylor did not have medical insurance when he was injured near his home, but he was immediately enrolled in the Healthy Indiana Plan after his arrival at Methodist, his mother said.
“(Methodist) was right on top of it, and now he’s fully covered,” Christine Taylor said. “All I can say are wonderful great things about those folks.”
The HIP plan covers adults age 19 to 64 ineligible for other government medical services whose incomes are less than 138 percent of the federal poverty level.
There’s no argument that air ambulances — such the IU Health LifeLine helicopter that airlifted Taylor — save lives, said Capt. Mike Wilson, spokesman for the Columbus Fire Department.
When compared to ground ambulances, a medical helicopter can usually knock about a quarter of the transport time from Columbus Regional Hospital to IU Health Methodist, Wilson estimated.
Variables such as weather, accidents, and rush hour traffic can add an extra 15 minutes to the ground ambulance, as opposed to “clear blue skies with no obstructions,” Wilson said.
STUDY IN LIFESAVING
A 2010 study by Dalhausie University in Nova Scotia, Canada, shows that for every 100 patients, the lives of 5.61 more patients are saved through using air, rather than ground ambulances. By logging an average of 10 critical care responses in Bartholomew County each month, LifeLine has become “an essential element to local EMS systems,” Wilson said.
Just five Indiana communities — Indianapolis, Lafayette, Richmond, Terre Haute and Columbus — have LifeLine helicopters stationed in their area. Five other similar but smaller hospital-based medical helicopter operators are listed by the Indiana Association of Air Medical Services.
In a state with 92 counties, that leaves many Hoosiers being served by for-profit, private air-ambulances.
“Some for-profit medical transport programs charge an average flat rate of $30,000 per flight,” Ford said.
While some Hoosiers demanded that Indiana lawmakers step in on their behalf, that’s not expected to happen. A 1978 federal deregulation act prohibits states from setting any controls over air ambulance costs, along with commercial flights, according to the Indiana Department of Insurance.
Besides private insurers, the federal government is also capping reimbursements for air ambulance flights. Medicare will pay about $4,400 per takeoff and about $12.50 per mile, according to the Association of Air Medical Services.
Both private and government insurers will cover service to the closest most appropriate facility, as determined by whoever has the most experience that is immediately available for consultation, according to IU Health, CRH and emergency services personnel.
IU Health Methodist Hospital would be the closest most appropriate Level 1 Trauma Center to Bartholomew County if the patient is an adult with traumatic injuries, Ford said. Riley Hospital for Children at IU Health is the closest most appropriate level 1 Trauma Center for pediatric patients with traumatic injuries.
Since every medical emergency is different and seconds could spell the difference between life and death, hospital representatives and first responders say the last thing any seriously injured or ill person needs is time lost from indecision on where treatment ought to be sought.
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Members of the Indiana Association of Air Medical Services
- IU Health Lifeline
- Air Evac
- Lutheran Air
- Memorial MedFlight
- Parkview Samaritan
- St. Vincent StatFlight
- St. Mary’s LifeFlight
- Air Methods Kentucky
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