(WBRE/WYOU) — Medical helicopters are something many of us hope to never need, but if you do, are you prepared to pay a hefty price tag?
Even if you have insurance, it’s possible to get stuck with a $20,000, $30,000, or even a $40,000 bill for those life-saving services.
It’s something Gary Karwaski found out first-hand after he fell off the roof of his Pike County cabin in June 2015.
“I broke my femur, crushed my hip, and I fractured a couple vertebrae in my back,” said Karwaski.
But the pharmacist from Luzerne County said his heart didn’t skip a beat until he got the bill about two weeks later.
For a 24-mile flight from Promised Land State Park to Geisinger Community Medical Center in Scranton, Karwaski was charged $42,569.20.
His insurance company only covered about $12,000, leaving him with the $30,000 balance. He said the only breakdown of the charges is the lift fee and the number of miles flown.
A spokesperson for the medical helicopter provider Air Methods, doing business as Rocky Mountain Holdings LLC, told Eyewitness News the lift fee includes the aircraft, state-of-the-art medical equipment, an EMS pilot, fuel, and other services, but didn’t provide any specific figures.
“It was so aggravating and stressful, almost as stressful as the accident itself!” said Karwaski.
Karwaski said he was overwhelmed by phone calls and letters from Rocky Mountain Holdings LLC, demanding money he didn’t have.
He said the company offered to come to an agreement, but only if he provided his tax returns, investments, and other financial information, which Karwaski declined to do.
The spokesperson said it’s part of the qualification process to offer assistance that matches the patient’s level of need.
“If I had more, I should pay more, but if I had nothing, then I’m OK?” asked Karwaski. “That doesn’t make sense!”
Karwaski’s account was handed over to a collection agency, so he hired an attorney and settled for $7,500.
A large part of the problem when it comes to sky-high bills is dramatically low government reimbursement rates, at least according to Save Our Air Medical Resources or S.O.A.R.
Carter Johnson with that campaign told Eyewitness News in a Skype interview that seven out of ten transports are patients who have Medicare, Medicaid, or no insurance at all.
Pennsylvania has the lowest Medicaid reimbursement in the nation for air ambulance services, only covering about $200 when the fuel alone can cost about $450.
“When they’re transported, the cost of that is being shifted onto the 30% of folks who have private insurance, and that’s just unsustainable,” said Johnson.
Jessica Altman is the Acting Insurance Commissioner for the Pennsylvania Insurance Department.
She said right now there’s not much the Commonwealth can do to protect these patients, because a federal law prohibits states from regulating medical helicopters.
“So we’ve been looking to Congress, and there has been some interest in Congress taking action to allow states to regulate this situation,” said Altman.
But as each day goes by without a solution, Karwaski can only think about how many more people will have to suffer a financial hardship after the physical pain of a serious injury.
“My wife and I will be driving in the car, we’ll see a helicopter, and we’ll look at each other like, do they have any idea what awaits them?”
If you’re having problems with an air ambulance bill, you can file a complaint through the Pennsylvania Insurance Department.