Although you do not have to be a member to be transported, membership offers several important benefits:
First, as one of Trinity County Life Support (Ground Only) or Trinity County Medical Transport Alliance (Ground & Air) members, Trinity County Life Support, PHI Air Medical*, or AirMedCare Network* Providers will work on your behalf with your benefits provider to secure payment for your ground or flight, with any uncovered amounts considered to be fully prepaid. As such, members who are transported by Trinity County Life Support*, PHI Air Medical*, or AirMedCare Network* will not receive a bill for the ground or flight. Importantly, your membership is valid in each network’s service areas, so you are covered while traveling in those areas. If EMS agencies determine air medical transport is needed, they will dispatch PHI Air Medical* or AirMedCare Network* providers.
Second, becoming a Trinity County Life Support or Trinity County Medical Transport Alliance member is a good way to support the health care needs of your local community. Our membership base helps Trinity County Life Support operate in our rural areas within Trinity County where having a quick response time to critical medical situations can save lives.
* Trinity County Life Support is attached with both memberships.
*PHI Air Medical and AirMedCare Network are attached to the Trinity County Medical Transport Alliance membership (TCMTA).
An individual’s membership fee covers only a small fraction of the cost of a ground and/or ground and flight. Our membership support helps subsidize our program, but our primary revenue is derived from our transports, the vast majority of which are non-members; only a fraction of the patients we transport are Trinity County Life Support (Ground Only) or Trinity County Medical Transport Alliance (Ground & Air) members.
Medically necessary, emergency transport (when available) by a Trinity County Life Support (Ground Only) or Trinity County Medical Transport Alliance (Ground & Air) provider to the closest appropriate medical facility for medical conditions deemed by an attending medical professional to be life- or limb-threatening, or that could lead to permanent disability. Members receive a welcome packet complete with auto stickers and membership cards. Members have the peace of mind knowing that they will receive no out-of-pocket expense for their ground and/or ground & air ambulance.
With a Trinity County Life Support (Ground Only) or Trinity County Medical Transport Alliance (Ground & Air) household membership, any person or persons who reside under one (residential) roof can be covered. In the event we have a member who lives in a duplex or apartment complex, we designate the primary member’s residence/address, and that is considered the “one roof”. Undergraduate college students can be covered under their parent’s membership as well as anyone previously residing in the household who is then moved to a permanent care facility.
There is no limit to the number of emergency transports a member may take in a year. Each transport is handled the same way and must be a medical necessity is defined as a specific need for ambulance transportation to or from a healthcare facility (911 emergency or inter-faculty transfer), where use of other forms of transportation would be medically inappropriate or detrimental to the patient.
*Abuse of the service, if found to exist, may result in termination of membership.
If a Trinity County Life Support, PHI Air Medical, or AirMedCare Network Provider does not transport you, you will be responsible for payment of the bill. The Trinity County Life Support or Trinity County Medical Transport Alliance membership program/s only covers transports provided by Trinity County Life Support, PHI Air Medical, or AirMedCare Network.
PREPAID PROTECTION FOR MEMBERS
No. Trinity County Life Support, PHI Air Medical, AirMedCare Network are not insurance companies. A Trinity County Life Support or Trinity County Medical Transport Alliance membership is not an insurance policy and cannot be considered as secondary insurance coverage or as supplemental coverage to any insurance policy. Membership provides prepaid protection against covered Trinity County Life Support, PHI Air Medical, AirMedCAre Network provider transportation costs that exceed a member’s health insurance or medical benefits.
This answer varies, with each insurance company offering different plans and coverage. It is up to your individual insurance company as to whether they will cover the cost of a transport, as well as to the amount of economic burden placed on the patient via a co-pay or deductible. We recommend that you contact your insurance company directly to obtain detailed coverage information.
Most insurance companies will pay 100% of what they deem an allowable amount for emergent ground and/or ground and flight, which does not necessarily mean that the total cost of the transport will be covered. Additionally, people frequently change insurance companies and plan designs. You will want to check with your individual insurance company to find out exactly how much they will cover in the case of a Trinity County Life Support or Trinity County Medical Transport Alliance transport. Lastly, your insurance may decide that the ground or flight does not fit a specific parameter covered under your policy and deny payment. Membership will cover the cost of the ground and/or ground & flight memberships for you, even if your insurance does not.
No. Some state laws prohibit Medi-Cal or Medicaid beneficiaries from being offered membership or accepted into membership programs. As part of our application process, members certify to Trinity County Life Support that they are not Medi-Cal or Medicaid beneficiaries, with Trinity County Life Support, accepting Medi-Cal or Medicaid as full payment for services rendered.
The answer varies, depending upon the nature of your transport and your supplemental insurance provider. In many cases, Medicare and the supplemental insurance coverage should pay for the cost of transport if it is medically necessary and if Medicare believes you were taken to the closest appropriate hospital. However, we have seen cases where the supplemental insurance provider does not cover a remaining balance after Medicare has paid its portion. Many seniors have said they want a membership even if they have complete coverage, in the event that their insurance coverage changes in the future or if the claim is denied. Often times supplemental insurance will not pay if your primary denies. In those circumstances, membership is very beneficial.
PROVISION OF SERVICES
Call your local 911 service. The 911 dispatchers are trained to get specific information about the medical emergency from the caller and determine what type of medical transportation best fits the situation, so the best option is to always call the local 911 service first. The local service is more familiar with your location, as well as the availability of the local emergency resources.
When calling emergency personnel, you may make the 911 ground or air ambulance service aware that you are a Trinity County Life Support (Ground ONLY) / Trinity County Medical Transport (Ground & Air) member so that in the event they plan to request an air ambulance, they know your preference is for either PHI Air Medical or AirMedCare Network provider. Members receive an identification card and stickers for your vehicle. All of these items allow emergency personnel to identify that you are a Trinity County Life Support (Ground Only) / Trinity County Medical Transport (Ground & Air) member. Regardless of whether or not emergency personnel know that you are a Trinity County Life Support or Trinity County Medical Transport Alliance member, we may still be called to transport you. As earlier indicated, most of our transports are non-member transports.
If your medical emergency meets certain criteria, such as a heart attack, stroke or a traumatic injury and the 911 dispatcher determines you would benefit from emergent ground or air medical transport, they may dispatch a ground and/or air ambulance to your emergency. Hospital-to-hospital transfers are ordered by physicians.
Ground and/or ground & air ambulances are valuable and scarce resources that should be reserved for those times when a patient is facing medical necessity defined as a specific need for ambulance transportation to or from a healthcare facility (911 emergency or inter-facility transfer), where use of other forms of transportation would be medically inappropriate or detrimental to the patient. PHI Air Medical or AirMedCare Network Providers will not transport patients by air if air transportation is not believed to be appropriate.
When a ground and /or ground and air ambulance provider is called, time is of the essence. Patients in life threatening situations often need specialty centers to provide the interventions needed. Trinity County Life Support, PHI Air Medical, and/or AirMedCare Network Providers will take a patient to the closest appropriate medical facility as determined by physicians or EMS personnel. Whenever possible, physicians or EMS personnel consult with the patient or the patient’s families as these decisions are being made.
There may be times when the ground and/or ground and Flight ambulance in your area is committed to assisting another patient transport or is out of service for maintenance or inclement weather.
The primary determinant of whether to accept a ground and/or ground & flight is always the safety of the patient and the medical crews.
Trinity County Life Support crews are on duty and available 24 hours a day, 7 days a week. We may be unable to respond within a medically appropriate period due to unexpected high call volume, road closures, inclement weather, equipment limitations, or mechanical failure. In that event, mutual aid may be requested from a neighboring County.
PHI Air Medical Air Ambulance makes every effort to respond to requests from our members. We have flight crews and aircraft on duty and available 24 hours a day, 7 days a week. However, one of the following situations could result in PHI Air Medical being unavailable to respond: PHI Air Medical may be dedicated to a prior patient transport, weather conditions may prevent flying in your area, you may be in a location where their aircraft cannot land, and you have to be transported to the aircraft by a ground ambulance. PHI Air Medical Membership does not cover ground.
REACH Air Medical Service AirMedCare Network makes every effort to respond. The primary determinant of whether to accept a flight is always the safety of the patient and our medical flight crews. Federal Aviation Administration restrictions prohibit AirMedCare Network provider from transporting patients under certain conditions, such as, but not limited to, flying in inclement weather, equipment manufacturer limitations, maintenance requirements, age or size.
COLLABORATION WITH OTHER HEALTHCARE PROVIDERS
Our crews work and train closely with other EMS agencies and air ambulance services in our service areas. We recognize that good patient care requires a team effort of everyone involved – from first response and law enforcement officials to air ambulance and hospital personnel. We all play separate, but very important roles, in getting the patient to the appropriate medical care.
Yes. PHI Air Medical and AirMedCare Network Providers work very closely with Trinity County Life Support, and ground EMS agencies. These agencies request PHI Air Medical or AirMedCare Network to transport their patients when medically necessary. PHI Air Medical or AirMedCare Network also provides appropriate training and education for ground EMS agencies.
No. Trinity County Life Support is strongly committed to complying with all applicable healthcare regulatory guidelines, as well as all rules and regulations governing its participation in both Medicare and state Med-Cal or Medicaid programs. In order to avoid even the appearance on non-compliance with applicable healthcare regulatory guidelines, Trinity County Life Support does not offer discounted memberships to people just because they are healthcare or emergency personnel, given that such special discounts to healthcare or emergency personnel might be viewed as an attempt to influence referrals.
For other unaffiliated ground or air medical providers, we do not believe so. Federal law prohibits the routine waiver of co-pays for services covered by Medicare, Med-Cal, or Medicaid. However, through a ground and air ambulance membership program, membership fees are collected in lieu of the collection of co-pays (“co-pays” is used to refer to all types of patient cost-sharing amounts, including co-payments and deductibles). OIG guidance provides that where membership fees collected from members (or members who are Medicare beneficiaries) “reasonably approximate” the amounts that these individuals would expect to spend for cost-sharing amounts over the period covered by the membership agreement, there is, essentially, no impermissible waiver of co-pays. Therefore, where a specific ground and air ambulance supplier (such as Trinity County Life Support, PHI Air Medical, or AirMedCare Network) operates a membership program and does not bill its members for co-pays associated with its ground and/or ground & air transport services, this would not be considered to be a prohibited waiver of the co-pays (i.e., the billing and collection of the membership fee would negate any obligation of the specific ground and/or ground & air ambulance supplier to bill the patient for the co-pay). This analysis does not hold true, however, if a separate, unaffiliated supplier of air transport services (such as an unaffiliated competitor to Trinity County Life Support, PHI Air Medical, or AirMedCare Network) waives a co-pay for services provided to a Trinity County Life Support, PHI Air Medical, or AirMedCare Network member. In this case, the competitor has not collected any membership fees from the Trinity County Life Support, PHI Air Medical, or AirMedCare Network member, because these fees have only been collected by Trinity County Life Support, PHI Air Medical, or AirMedCare Network. As a result, the competitor has not collected any funds from the patient that would justify refraining from billing the Trinity County Life Support, PHI Air Medical, or AirMedCare Network member for the co-pay. In summary, if a competitor provides services to a Trinity County Life Support, PHI Air Medical, or AirMedCare Network member, the competitor is obligated to collect a co-pay from that individual (unless, of course, the Trinity County Life Support, PHI Air Medical, AirMedCare Network member is also a member of a qualifying membership program operated by the competitor).
No, for the reasons described above. While Trinity County Life Support, PHI Air Medical, or AirMedCare Network appreciates operating under a team-oriented approach to provide the highest levels of patient care and service in the regions it serves, it is strongly committed to complying with all applicable healthcare regulatory guidelines, as well as all rules and regulations governing its participation in both Medicare and state Medi-Cal or Medicaid programs, and therefore cannot honor other unaffiliated air medical provider memberships.
"A Word from the California Department of Managed Health Care:"
(A) BEFORE YOU PURCHASE: If you are currently enrolled in a health maintenance organization (HMO) or other health insurance, the benefits provided by an Ambulance Plan may duplicate the benefits provided by your HMO or other health insurance. If you have a question regarding whether your HMO or other health insurance offers benefits for ambulance services, you should contact that other company directly.
(B) WARNING: This Ambulance Plan is not an insurance program. It will not compensate or reimburse another ambulance company that provides emergency transportation to you or your family. This may occur when the 911 Emergency System has independently determined that another company could provide more expeditious service or is next in the rotation to receive a call. This might also occur when this Ambulance Plan is unable to perform within a medically appropriate time frame due to a mechanical or maintenance problem or being on another call.
(C) COMPLAINTS: For complaints regarding TRINITY COUNTY LIFE SUPPORT, PHI, AND AirMedCare Network REACH/CALSTAR/Cal-Ore. If you have questions regarding the Plan, first attempt to call Trinity County Life Support at 530-623-2500 (Weaverville Office). If Trinity County Life Support fails to resolve the complaint to your satisfaction, contact the Department of Managed Health Care at 1-888-466-2219. The Department’s website is http://www.healthhelp.ca.gov. You may obtain complaint forms and instructions online.
(D) OPERATING UNDER CONDITIONAL EXEMPTION: This Ambulance Plan is operating pursuant to an exemption from the Knox-Keene Health Care Service Plan Act of 1975 (Health and Safety Code section 1340 ct seq.).
Air Ambulance FAQs & Membership Benefits:
For more information, please feel free to contact:
Trinity County Life Support Membership Coordinator
610 Washington Street
P.O. Box 2907
Weaverville CA 96093