Ambulance bill frequently asked questions
Why is Boston EMS not contracted with my health insurance provider?
Federal and state regulations require emergency medical providers, including ambulance services and hospitals, to treat all emergency patients and for health plans to cover needed care. According to Massachusetts General Law, Chapter 176G, Section 5:
“(e) A health maintenance organization shall clearly state in its brochures, contracts, policy manuals and printed materials that members shall have the option of calling the local pre-hospital emergency medical service system by dialing the emergency telephone access number 911, or its local equivalent, whenever an enrollee is confronted with an emergency medical condition which in the judgment of a prudent layperson would require pre-hospital emergency services. No member shall in any way be discouraged from using the local pre-hospital emergency medical service system, the 911 telephone number, or the local equivalent, or be denied coverage for medical and transportation expenses incurred as a result of an emergency medical condition.”
What do I do if my insurance does not honor the full amount because they say Boston EMS is out of network?
When this occurs, please call your insurance company. Tell them that they are obligated to honor the full amount of the ambulance bill in accordance with Massachusetts General Law, Chapter 176G, Section 5. Boston EMS only bills patients the amount their insurance company determines to be their responsibility. It can be difficult to differentiate between amounts assigned to patients by their insurance company due to:
- co-pay, or
- a deductible.
As a patient, you should only be required to pay your co-pay or deductible.
What do I do if I am uninsured or have a copay/deductible that I can’t afford?
Boston EMS has a compassionate billing practice. This ensures ability to pay for an ambulance transport is never a barrier to calling 9-1-1 in a medical emergency. Please call 844-353-7842 to discuss options available to you.
Why does Boston EMS charge for services when the City’s Fire and Police Departments do not?
Ambulance transports are reimbursable by insurance companies. Most patients have insurance that covers this service. For that reason, we believe it is appropriate to charge for transports to offset operational costs. That said, running a 9-1-1 EMS in an urban city is not a profitable endeavor. The department’s budget is jointly funded by transport revenue and a city of Boston subsidy.
How are the Boston EMS transport rates established?
In 2018, Boston EMS worked with a firm contracted by the City of Boston. We analyzed ambulance transport fees across the state to determine a fair rate. The fees were reviewed internally and approved by the Boston Public Health Commission and City of Boston. Each January, the rate is adjusted in accordance with the medical consumer price index. The department is able to keep transport rates below cost through a City of Boston subsidy.
What do the transport bills pay for?
As a municipal service, we are not-for-profit. All revenue goes directly to covering operational costs. In fact, 85% of payment on a transport bill will go toward personnel costs. This covers wages and benefits for our 425 department members, the majority of whom work in ambulances or at dispatch operations. The rest covers everything from medical equipment and supplies to ambulance fuel and maintenance costs.