If I Call an Ambulance for Someone Else, Who Pays?

If you find yourself in a situation where you call an ambulance for someone else, a common concern might be who will be responsible for the associated costs. It is important to understand that, in most instances, the individual who initiates the emergency call for another person is not held financially accountable for the ambulance services rendered. The primary focus of emergency services is to provide timely medical care, ensuring that fear of financial burden does not deter necessary intervention.

Primary Responsibility for Ambulance Costs

The financial responsibility for ambulance services typically rests with the patient who receives the care. This means the individual transported by the ambulance, or their health insurance provider, is generally billed for the service. Even if a patient is unconscious or unable to communicate, they are still considered the financially responsible party for medically necessary ambulance transport.

When the patient is a minor, the financial obligation for ambulance services usually falls to their legal guardian or parent. This responsibility often extends to their insurance coverage. If a patient passes away, the ambulance bill then becomes a liability of their estate. Should an estate lack sufficient assets to cover the debt, the bill may ultimately be forfeited as uncollectible.

Ambulance services can issue charges even if a patient is not transported to a hospital. This can occur if emergency medical personnel provide on-scene assessment or treatment, as their response incurs operational costs. Most ambulance providers, whether private or municipal, operate on a fee-for-service model.

Understanding Ambulance Billing

Ambulance services are typically billed through a process involving the patient’s health insurance. Health insurance plans generally cover medically necessary ambulance transport, but patients are often responsible for out-of-pocket expenses such as deductibles, co-payments, and co-insurance. A deductible is the amount a patient must pay before their insurance begins to cover costs, while co-payments are fixed amounts paid for a service, and co-insurance is a percentage of the cost shared with the insurer after the deductible is met.

Out-of-network charges are a significant challenge in ambulance billing. Many ambulance providers do not have contracts with all health insurance companies, leading to “surprise billing” where patients receive unexpected bills for the difference between the provider’s charge and what their insurance pays. The federal No Surprises Act, implemented in 2022, provides protections against surprise billing for many medical services, including air ambulance transport. However, it generally does not apply to ground ambulance services. Some states have enacted their own laws to protect consumers from surprise ground ambulance bills, which can cap patient liability or prohibit balance billing.

Distinctions are made between emergency and non-emergency ambulance transport for billing purposes. Emergency services, usually initiated by a 911 call for life-threatening situations, do not require advance approval from an insurer. Non-emergency transport, such as scheduled transfers between medical facilities, typically requires a doctor’s certification of medical necessity and often pre-authorization from the insurance provider. Medicare, for example, may cover non-emergency transport if the patient’s medical condition prevents them from traveling by other means. The total bill can include charges for the service level (e.g., Basic Life Support, Advanced Life Support), mileage, and any medical supplies or procedures administered during transport.

Addressing Unpaid Ambulance Bills

Patients facing an ambulance bill they struggle to pay have several avenues to explore. One approach is to negotiate directly with the ambulance provider. Many providers are willing to discuss a reduced lump-sum payment or establish a manageable payment plan, particularly if the patient demonstrates financial hardship. Requesting an itemized bill is an important first step, as it allows patients to review charges for accuracy and identify any potential errors.

Financial assistance programs, often referred to as “charity care,” are another option. Many ambulance services and hospitals offer these programs to eligible individuals based on income criteria. These programs can help cover deductibles, co-insurance, or the entire cost for uninsured patients. Medicaid also covers ambulance transportation for eligible enrollees, providing a safety net.

If a bill remains unpaid, it may be sent to collections, which can impact a patient’s credit score. Recent changes in credit reporting policies, effective March 2023, have altered how medical debt impacts credit. Paid medical collection accounts are now removed from credit reports, and medical debts under $500 are generally excluded. Additionally, a one-year waiting period exists before unpaid medical bills are reported to credit bureaus, providing time to resolve the debt. If the debt is reported, it can remain on a credit report for up to seven years.