What To Do When You Can’t Pay Your Ambulance Bill

Ambulance rides can be extremely expensive, often costing thousands of dollars even for short trips. If you’ve received a surprisingly high ambulance bill that you can’t afford to pay, you have options. You don’t necessarily have to pay the full amount right away, if at all. Here’s what to know about negotiating, lowering, and covering ambulance bills you can’t afford.

Understand Why Ambulance Bills Are So High

Ambulance services are very expensive to operate and maintain. The vehicles, fuel, medical equipment, staffing, training, insurance, and other overhead costs add up. Most ambulance companies are privately run businesses that need to cover their costs and make a profit.

Because Medicare and Medicaid pay ambulance companies very little, they have to charge people with private insurance or no insurance more to make up the difference. Patients who don’t have insurance are charged the full rate, with no discounts, which can be thousands of dollars.

Check Your Insurance Coverage

If you have health insurance check your policy or call your insurer to see what ambulance services are covered. Most plans cover emergency ambulance transportation to some extent but coverage varies. Ask

• Is this ambulance company in-network or out-of-network? In-network is better.

• How much of the ambulance bill is covered by in-network or out-of-network insurance? Usually, 80% is covered by in-network insurance and 20% is covered by out-of-network insurance.

• Does the benefit go up to a certain amount each trip or each year? Usually, the limits are between $700 and $2500 per ride.

• Does the copay or coinsurance apply to your deductible?

• Do you need prior authorization for non-emergency ambulance trips?

Knowing what your insurance covers will help you figure out how much things will cost and what to do next. Submit an insurance claim as soon as possible.

Negotiate the Bill

If you lack insurance or have high out-of-pocket costs, try negotiating directly with the ambulance company. Many are willing to charge uninsured patients their lowest reasonable rate or set up manageable payment plans.

Be polite and explain your financial hardship. Offer to pay a portion, like 20-40% of the bill, as a lump sum if they’ll accept it as payment in full. Or ask to make reasonable monthly payments over 6-12 months. Get any agreed deal in writing before paying.

If the ambulance company won’t negotiate, ask for a detailed bill justification and proof they legally require you to pay the amount billed. Ambulance companies sometimes inflate bills and add excessive fees beyond what’s reasonable. Don’t hesitate to negotiate multiple times if needed.

Seek Bill Reduction Programs

Many ambulance companies participate in financial assistance programs or offer their own hardship provisions. For example:

• Uninsured or underinsured patients may qualify for a reduced bill under their state laws or company policies. Income requirements vary.

• Nonprofit hospitals often have charity care programs covering ambulance bills from private companies they work with.

• Ask if they offer prompt payment discounts for paying the entire bill immediately, often within 30 days. Discounts of 10-30% are common.

• If the ambulance company bills through a debt collection agency, negotiate with the agency. They often accept lower payments.

Check the ambulance company’s website or call their billing department to learn about any bill reduction or financial assistance programs.

Apply For Community Assistance

If you still can’t afford the ambulance bill, various nonprofit community organizations may be able to help, such as:

• Hospital charity care programs – Ask the hospital social worker.

• Local churches, mosques, synagogues, or religious charities – Many offer one-time financial aid.

• Crowdfunding sites like GoFundMe.com – Create an online fundraising campaign for medical bills.

• Local service clubs like Lions Clubs International – They aid with medical bills.

• State and national associations like the Patient Advocate Foundation – Provides co-pay assistance.

Search “[your city] pay medical bills assistance” to find local resources. Be persistent and cast a wide net for help.

Work Out a Payment Plan

Rather than paying a lump sum, offer the ambulance company reasonable monthly payments over 6-12 months. Make the payments automatically via post-dated checks, bank auto-pay, or their online payment portal. Get any payment plan agreement in writing before starting payments.

If the monthly payment amount they request is still unaffordable, negotiate a lower payment. Explain your budget constraints and don’t accept a payment plan that overextends your finances.

Consider Medical Credit Cards

Medical credit cards like CareCredit let you charge medical bills up to a certain limit then pay it off over time. This can free up cash flow to start making payments right away. Compare cards to find the best rates and terms.

Use medical credit cards cautiously, however. The deferred interest and penalties can pile up fast if you don’t pay off the balance during the promotional period. The high regular interest rates also make these a last resort option.

Negotiate With Collections

If your overdue ambulance bill gets turned over to a collections agency, don’t panic. The collections agency just wants to get paid and may accept less than the full amount. Politely negotiate to settle the debt at a discount, such as:

• Offer a lump sum payment of 20-50% of the balance and ask them to remove it from your credit report.

• Propose a monthly payment plan at an affordable level to steadily repay it over time.

Get any deal to “pay for delete” the item from your credit report in writing before paying. Be aware collections debts on your credit report can lower your score for up to 7 years.

Seek Legal Advice

In certain cases, you may not be obligated to pay the ambulance bill, such as:

• You didn’t consent to the ambulance ride while fully conscious and alert.

• The ambulance company violated insurance network agreements.

• You qualify for a reduced-cost care program that the ambulance company won’t honor.

Consult a lawyer to understand your rights and options. There are consumer protection laws regarding unfair billing practices or price gouging on medical bills.

Declare Bankruptcy

As a very last resort if you have many unaffordable medical debts, you may need to declare Chapter 7 or Chapter 13 bankruptcy. This legally eliminates or restructures debts you can’t pay. The bankruptcy ruins your credit for years but gives you a fresh start free of crushing debt. Talk to a bankruptcy lawyer and financial advisor first.

Avoid Future Surprise Ambulance Bills

Once you resolve the current ambulance bill, take steps to prevent another unaffordable bill down the road:

• Get health insurance if you currently lack coverage. Shop marketplace plans.

• Consider supplemental insurance just for ambulance services as a cost-saving buffer.

• Ask your insurer for in-network ambulance providers to request by name in an emergency. Out-of-network trips cost more.

• Set aside $50-100 per month in a savings fund just for medical expenses like ambulance copays or coinsurance.

• Make sure family members know to inquire about ambulance costs and insurance coverage for you if you’re incapacitated.

• Be an informed health care consumer and seek financial assistance programs before large medical bills arrive.

Facing an expensive ambulance bill can be scary and stressful. But stay calm, get informed, negotiate firmly yet politely, and take advantage of all available financial assistance resources. With perseverance and creativity, you can likely reach a reasonable resolution without paying the full amount upfront. Don’t let bills force you into bankruptcy or long-term debt – take control and work towards a payment plan you can realistically manage.