Alex Gonzalez, Producer
A new report says Arizonans who have a medical emergency and good health insurance could still find themselves with a costly “surprise” bill.
The federal “No Surprises Act” is supposed to protect people from the high costs of out-of-network medical services.
But it doesn’t protect them from surprise ground ambulance costs – which Patricia Kelmar, senior director for Health Care Campaigns with the Arizona PIRG Education Fund, said is simply unfair.
The group’s new report says when Arizonans call 911, dispatchers will send the closest ambulance – and there’s a 50% chance it will be out-of-network and not covered by the patient’s insurance.
Kelmar said the national average for that ambulance bill is $450 – but in Arizona, it’s higher.
“Getting a bill of $586 or more is going to really set them back,” said Kelmar, “and we know that ambulance bills are driving people into medical debt. So, we need to put the brakes on it.”
While the report says changes are needed, it also acknowledges that ambulance services are necessary and providers should be paid an appropriate fee.
The report says ten states have already passed laws to protect patients from out-of-network ambulance bills – but they’re limited to people who have state-regulated health plans, which translates to about 40% of their population – and Arizona isn’t one of them.
Kelmar said most people get health insurance through their employer, and those plans are only required to follow federal law – not state law.
“The Arizona Legislature could certainly step forward and not wait for a federal solution,” said Kelmar, “and at least put some surprise billing protections in place for people in Arizona from ground ambulances. And then, we can continue to fight for a federal solution.”
She said that federal solution would mean protecting people with employer-sponsored insurance.
Kelmar said the most important thing is to get the medical attention you need, then work to negotiate what you can pay.
She added that some hospitals provide financial assistance, so ask to see if you qualify.
Disclosure: Arizona PIRG Education Fund contributes to our fund for reporting on Budget Policy & Priorities, Consumer Issues, Energy Policy, Urban Planning/Transportation. If you would like to help support news in the public interest, click here.
References:
NEWS RELEASE: National solution needed to put brakes on ambulance surprise bills U.S. PIRG Education Fund 12/13/22
Consumers: new protections against surprise medical bills CMS 11/23/22
