A Connecticut man turned to NBC10 Boston Responds for help after an ambulance ride left him facing a bill of nearly $6,000, raising questions about why emergency transport can be so expensive, and what options patients have when costs spiral.<\/p>\n
Stephen Wass was working on a construction site in Chelsea, Massachusetts when he suddenly felt chest pain and became lightheaded. Concerned about his health, he asked for an ambulance to be called.<\/p>\n
\u201cIt was a three-mile ride and a $6,000 bill,\u201d Wass said.<\/p>\n
The invoice, reviewed by NBC10 Boston, shows Action Ambulance charged $6,343.41 for the emergency transport. Wass\u2019 Tufts Health Plan initially covered just under $600, leaving him responsible for $5,745.25.<\/p>\n
\u201cLooking at that number right now, it makes my stomach turn,\u201d he said. \u201cThinking about that hanging over my head\u2014I\u2019d still be paying it.\u201d <\/p>\n
Wass noted the cost of the ambulance ride was significantly higher than his hospital care.<\/p>\n
\u201cMass General was almost half the cost of the ambulance ride,\u201d he said.<\/p>\n
You’re calling 911. You have no choice on who shows up. And obviously it’s a life-or-death situation in most cases. So how do you then say no?<\/p>\n
Stephen Wass<\/p>\n
Why the bill was so high<\/p>\n
When Wass challenged the charge, he learned the ambulance company that transported him was out of network with his health insurance plan.<\/p>\n
In an email to NBC10 Boston, a spokesperson for Point32Health\u2014the parent company of Tufts Health Plan\u2014explained:<\/p>\n
\u201cPoint32Health is committed to ensuring our members access to care is not disrupted and we have long advocated for out of network protections for members during emergency situations at both the state and federal level. Mr. Wass was transported by a non-contracted ambulance company. Many ambulance providers do not contract with health plans for emergency services, and there is no upper limit on what ambulance providers can charge many health plan members.\u201d<\/p>\n
\u201cIt doesn\u2019t seem right that they can make up their own rate,\u201d said Wass. \u201cYou’re calling 911. You have no choice on who shows up. And obviously it’s a life-or-death situation in most cases. So how do you then say no?\u201d<\/p>\n
After NBC10 Boston Responds contacted both the ambulance company and the insurance provider, Wass\u2019s claim was reprocessed. His bill dropped to about $30.<\/p>\n
\u201cI\u2019m here and very lucky that I got help,\u201d Wass said. \u201cBut on the other hand, I was still upset that they can continue to do this. And I’m sure there are other people that may not be as persistent to make those calls to try to find another way. And maybe they may have to choose between paying their heat bill or food bill and to pay an ambulance bill.\u201d<\/p>\n
Why ambulance bills are so complicated<\/p>\n
Ambulance services in the U.S. are provided through a patchwork system. When you call 911, an ambulance might be responding from a municipal fire department or a private provider. That can range from hospital-based ambulance services to nonprofit public safety organizations to for-profit companies. There are almost as many ambulance services in Massachusetts \u2014 314 \u2014 as there are municipalities \u2014 351. Further complicating things, cities may have backup and mutual aid agreements with ambulance providers to respond when needed. So, it\u2019s hard for the patient to know who is going to respond, let alone whether they have a contract with their health insurance provider.<\/p>\n
The Massachusetts Attorney General\u2019s office examined ambulance billing in a 2023 report.\u00a0 They found two- thirds (67%) of emergency transports they reviewed involved out-of-network providers, which often results in higher out-of-pocket costs for patients\u2014called \u201cbalance billing.\u201d They also found that some ambulance transfer rates are more than four times what Medicare would pay for the exact same service.<\/p>\n
What ambulance companies and insurers say<\/p>\n
\u201cThese prices, even though they appear to be shocking, are typically a result of the lower prices that government payers are reimbursing us. The number also reflects the cost to provide service as well,\u201d said Michael Waronka, CEO of Action Ambulance, the company that responded to Wass\u2019 emergency.<\/p>\n
He points to insurance companies, saying their reimbursement rates often do not fully cover the cost of service.<\/p>\n
\u201cIt’s a very common tactic amongst most of the commercial payers. And what we call it is repricing. They arbitrarily will reprice the invoice,\u201d said Waronka. \u201cAnd then what we have to do is work with the patient to go back and talk to the insurer through the patient to be able to get a higher level of reimbursement in the end from the insurer.\u201d<\/p>\n
Lora Pellegrini, president and CEO of the Massachusetts Association of Health Plans, pointed back to ambulance companies.<\/p>\n