Do You Have to Get in the Ambulance? Understanding Your Options
If you are the passenger in an ambulance, odds are pretty good you are not having a good day. But even that day may not be as bad as the one you have when you find a bill in your mailbox for a ride you had no choice to take. If you are unconscious, you obviously cannot voice an opinion, but if you are conscious and able to make a decision, can you refuse transport? And if you do refuse transport, will you be charged for it anyway? The answer is yes and no to both questions, depending on your circumstances.
In most cases, an adult who has the capacity to understand both their condition and the consequences to not receiving treatment have the right to refuse treatment or transfer to a medical facility via ambulance. Usually, you will need to sign a waiver, although even signing the waiver can be refused. You will need to demonstrate your full understanding of the consequences and may need to be forceful in your conviction in order to avoid a trip to the ER via ambulance. Many times emergency personnel may encourage you to “go to the hospital anyway just to get checked out”; however, it is your right to decide how you get there. You should only refuse transport if you are absolutely certain you are not in need of emergency medical treatment on the way to the hospital.
Who can’t refuse transport?
Depending on emancipation status, minors under 18 may not refuse transport (although their parent or guardian can), nor can someone who is incapacitated in such a way as to put their faculties in question – such as someone who is intoxicated, under the influence of drugs, previously diagnosed with a condition such as Alzheimer’s, or unconscious. (Please keep in mind this is not an exhaustive list – other circumstances may apply). When adults are conscious but have court-appointed guardians (such as in cases of dementia or Alzheimer’s), the guardian can refuse treatment on behalf of the adult.
A bill for WHAT?
So let’s say you are in a one-car minor fender bender resulting in a broken arm. The car is still drivable and your passenger is able to drive. A witness to the accident had called 911 and a police officer, fire engine, and ambulance shows up. You are given a ticket, and tell the ambulance personnel your passenger can drive you to the ER. You sign the waiver refusing transport and off you go to the hospital in your own car for x-rays and a cast, the ambulance goes off in the other direction. Two weeks later you receive a bill for $500 from the ambulance company even though all they did was show up and talk to you. Why? And do you have to pay it? The answer is tricky.
Sometimes your health insurance only covers an ambulance fee if there is a proven life-threatening emergency, sometimes the ambulance would be covered if they were part of a hospital that is in your network (but since ambulances are not dispatched based on insurance, but rather by proximity to the event and availability of the crew, the patient cannot control who arrives). Sometimes an ambulance dispatch is only partially covered due to coverage limits and the ambulance company is able to do what they call “balance billing” whereby they get as much of the fee as they can from the insurance company and bill the remainder to you. Occasionally your car insurance may cover medical costs, including the ambulance dispatch, if you sustain your injuries in a car-related incident. The list of variables goes on and on.
Why were you billed even if you didn’t ride in the ambulance and received no treatment?
Most often it is quite simply because they showed up. There was time taken away from other potential emergencies, and running an ambulance service is not cheap. In our example case, many car accidents DO require on-site treatment and transport to a hospital, so it was not unreasonable of the person who called 911 to do so, and it is standard procedure for 911 to send an ambulance to a car accident even if no injuries are immediately apparent or reported. This is true of many 911 calls. In some areas, you may not receive a bill unless you are physically transported or you received on-site treatment.
So what should you do?
Whatever you do, do not ignore the bill. Many times they will be turned over to a collection agency if left unpaid. Investigate. Call your insurance company to find out why it was not covered. Sometimes the reason for the ambulance being dispatched may have been coded incorrectly in the submission paperwork. If you exhaust that avenue, call the ambulance company directly as they may be willing to work with you to reduce the charge or set up a payment schedule.
Understand your coverage
While accidents are unpredictable, it never hurts to be informed. Check your health and car insurance now to know what is covered and what is not when it comes to ambulances. Find out which services in your area are in your network – in some places, you can request a specific ambulance company if you call for a home emergency, but if they are not available, another ambulance service may arrive. If you view the ambulance much the same way as you view the bills you will inevitably get from an emergency room visit when doctors, nurses, specialists, etc. are in and out of your room without your input – some of whom may be out of your network and for which you will receive a bill for their services later – it becomes clearer.