Ambulance Bills Continue to Surprise Patients, Even Federal Employees, as Costs Soar Beyond $600 Historical Example

A personal account shared by Thomas Maxwell on social media has cast a spotlight on the persistent issue of high ambulance costs, revealing how a seemingly steep $600 bill from his teenage years now pales in comparison to contemporary charges. Maxwell recounted an incident in Manhattan where, after falling off a bike, an ambulance was called without his request, leading to a bill for ten minutes of service despite his parents holding "gold star insurance" as federal employees. "My parents were both federal employees with gold star insurance and it was still $600," Maxwell stated in his tweet, expressing gratitude to NYU Langone.

This historical $600 charge for an ambulance ride is significantly lower than today's averages. Current data indicates that the national average cost for basic life support (BLS) ambulance rides is approximately $1,481, while advanced life support (ALS) services average around $1,613. In New York, these costs are even higher, with averages of $1,592 for BLS and $1,697 for ALS. The New York City Fire Department (FDNY) notably increased its ambulance fees by 54% in May 2023, with a basic life support ride now costing $1,385, plus an additional $20 per mile.

The federal No Surprises Act, enacted in January 2022, aimed to protect patients from unexpected medical bills, particularly for emergency services and out-of-network care at in-network facilities. While this legislation covers Federal Employees Health Benefits (FEHB) program carriers, which likely includes the "gold star insurance" Maxwell referenced, it contains a critical exemption. The Act's protections generally do not apply to ground ambulance services, leaving a significant gap in consumer safeguards against surprise billing for these essential emergency transports.

This exclusion means that individuals, even those with robust insurance coverage, can still face substantial out-of-pocket expenses for ground ambulance rides. In emergency situations, patients often have no control over which ambulance service responds or whether it is in-network, leading to unexpected bills. The lack of regulatory oversight for ground ambulance billing under the No Surprises Act continues to pose a financial burden on patients, highlighting an ongoing challenge in healthcare affordability and transparency.