Most everyone in the United States knows the high cost of health care. Even if you have high-quality, private insurance, you may not be covered in certain hospitals or for certain procedures. Additionally, if you are seriously injured in a car accident, you may not be able to choose treatment that suits your insurer. First responders could load you into a helicopter, potentially saving your life but putting you tens of thousands of dollars in debt. 
The High Cost of Air Ambulances
When emergency services arrive to the scene of an accident, they have to make split-second decisions. If your injuries seem serious and you are far from a major hospital, they might call in an air ambulance evacuation.
While most insurance companies will cover the costs of an ordinary ambulance ride, many have restrictions on how or when patients can be taken away by helicopter.
Even if your insurance does cover an air evacuation, you could still be billed for part of the service—and it likely will not be cheap. A recent crowdsourced study from National Public Radio and Kaiser Health News found that the average cost of a medevac helicopter ride ranges between $28,000 and $97,000. In some rare cases, patients have been charged up to $500,000 for a service that it is often provided without a patient’s explicit consent.
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Why Medevac Rides Cost So Much
Helicopter evacuations can save lives because they’re able to:
- Respond to accidents much faster than ordinary ambulances
- Transport patients to hospitals at high speeds
- Easily reach crash sites that might be inaccessible to ground crews
However, air ambulance companies have high operating costs because:
- Helicopter pilots and crews command much higher salaries than ordinary ambulance teams
- Helicopter pilots and crews must be ready to respond to emergencies at a moment’s notice
Increased competition means that air ambulance companies often have to fight for patients. But because they still have fixed operating costs, such as vehicle maintenance and flight crew salaries, competition often forces air ambulance companies to charge even more for their services.
Air ambulances are governed by a very different set of rules than ground ambulances. The federal government treats air ambulance companies as air carriers rather than health care providers. Since air carriers come under the jurisdiction of the Federal Aviation Administration, state regulators have no authority to cap their treatment fees—fees which can and often do stretch into the tens of thousands of dollars.
When an air ambulance transports a patient to the hospital, they may bill your insurance. However, insurance companies regularly refuse to pay the entire cost of a medevac flight. If there is an unpaid balance, the helicopter service can pass it on to an individual patient.
Why You Might Not Be Responsible for the Bill
If your health insurance company will not pay the costs of your helicopter evacuation, you could be stuck with an impossibly large bill. However, you may not have to pay. If another person’s negligence caused your injuries, they should be liable for the costs of treatment—not you. Since Missouri is an at-fault insurance state, the at-fault driver’s company should be responsible for your medevac flight.
