Don’t get stuck with a surprise bill
Understanding healthcare billing can be daunting, especially when it comes to services like emergency medical response. It can be easy to end up with an out-of-network bill. In fact, 86% of the privately insured end up with an out-of-network bill. And with more than 23,000 medical transport providers operating in the United States, and little centralized data about these services, it takes a bit of research to find out which providers might be deemed in-network by your insurance.
A helpful first step? Our Claims and Transport teams recommend reaching out to your insurance provider in advance to request a list of providers that are in-network.
What does in-network mean?
In-network refers to healthcare providers or services that have a contract with your health insurance plan. Providers and services can include your general practitioner, specialists, medical facilities, and ambulance companies, as well as other individuals and organizations that treat health conditions. These providers agree to accept the insurance company’s negotiated rates, which usually means lower out-of-pocket costs for you. When a medical transportation service is in-network, you benefit from reduced charges and more predictable expenses.
What can I do to better understand my coverage?
There are a few things you can do to better understand your health insurance coverage and determine what providers and services are in-network.
Before you experience an emergency:
Examine your insurance policy
- Review your benefits: Look for specifics on emergency services, including ambulance coverage. Some plans may have restrictions or special requirements.
- Know your network: Insurers often provide a list of in-network providers, including ambulance services, on their website or through customer service. Familiarizing yourself with the providers in your area can help you know what to expect if you are seeking care during an emergency later.
Contact your insurance company
If you’re unsure about whether a particular ambulance service is in-network, reach out to your insurance provider and ask for specifics about your plan. Request details about ambulance providers and confirm if a particular service is covered under your plan.
You’ll also want to ask your insurance company about how they cover emergency services. Some insurers may treat emergency services differently. Ask how your insurance company would handle a situation where you’re taken to an out-of-network facility by an out-of-network transport service.
Contact the provider
If you are seeking care from a provider or service for a non-emergent situation — such as paratransit, dialysis transfer, bariatric transport, or other limited mobility transport — you can always ask them if they are in-network with your insurance plan.
Explore government-mandated protections
The federal government, along with some states, may limit how much you can be billed for out-of-network emergency services. Research your state’s specific regulations for any additional protections.
My ambulance was deemed “out-of-network” — what can I do?
If you receive a bill for an out-of-network service, don’t panic. Carefully review the charges and double-check if the service is listed as out-of-network. If necessary, you can appeal the denial with your insurance company, if you believe the charges are incorrect or are higher than what you expected. When filing an appeal with your insurance company, provide all relevant documentation and be sure to communicate clearly.
What can I do during an emergency?
During an emergency situation you won’t be able to get detailed information on an ambulance service’s relationship with your insurance plan. 911 dispatchers aren’t trained to provide insurance information or dispatch according to your insurance plan — they are solely focused on getting you prompt care.
At MASA, we believe you shouldn’t have to worry about whether your ambulance is in-network, when facing an emergency. You can count on your MASA coverage to protect you from unexpected emergency medical transport costs, because you’re never out-of-network. If you already have MASA coverage, visit the member portal to review the benefits available to you and learn more about how to use them.
What can I do during an emergency?
Understanding your insurance coverage can make it easier to determine what services are in or out-of-network, and what you can expect if you receive a bill. Your MASA benefit ensures coverage for your emergency medical transportation needs, regardless of network. You’re always protected from emergency medical transport costs with comprehensive coverage and care you can rely on.
