The Nugget Newspaper - News and Opinion from Sisters, Oregon

What happens when you are, say, over on the Owhyee River fishing or halfway up Mount Thielsen and have a serious health emergency — and the nearest hospital is three or four hours away? Sounds like maybe you’d need or want to get an air ambulance. Not necessarily, even if you have a membership with one of the two providers offering such policies to residents in Sisters Country.

It’s just not that simple no matter what the brochure says. First of all no helicopter or plane will come get you just because you or a companion asked them to. It takes a licensed doctor or EMT (emergency medical technician) to authorize such a rescue, and then approval by the insurer. Then it can be a fairly complex project of finding a “bird” as they are called with a ready crew, and determining just exactly where they will transport you as the closest hospital may in fact not be able to treat the injury or have room.

It might be a three-hour drive or a 30-minute flight, but that’s once you get the “bird” at the scene, which is not instantaneous. A ground ambulance can average 55 mph and a helicopter up to 170 mph, giving the bird an obvious advantage.

Air transport may be required if you’ve been in an accident, or you might not survive a trip in a land ambulance. Like their ground counterparts, air ambulances have medical professionals on board, along with a mini-hospital in which they can begin treating you as you fly. You may need air transport when the alternatives would be dangerous to your health or would risk the success of a needed procedure. You may need it if you’re bleeding beyond the control of regular services or if you need oxygen, life support, or other aid during transportation.

Air ambulances are often used in cases involving stroke, heart attack, burn care, head or spinal cord injury, and transplant, where speed is of the essence. It’s also common when injury occurs in a remote place where ground transport isn’t accessible, say, deep in the woods or high in the mountains.

It can be complicated to say the least. That’s not to say that such insurance is an unwise investment third-party experts say. It’s like any insurance — a careful examination of risk and reward.

And, as Chief Roger Johnson said: “You don’t need it until you do.”

Then like all insurance there is the dreaded small print. Deductibles, co-pays, out-of-service areas coverage. Will Medicare reimburse? And much more. On that point, Medicare Part B will pay 80 percent of “approved” costs for air ambulance services. According to the American Journal of Managed Care, the average charge associated with fixed-wing air ambulance transports rose 27.6 percent, from $19,210 in 2017 to $24,507 in 2020. The average Medicare reimbursement rose 4.7%, from $3,071 to $3,216.

The average charge associated with helicopter air ambulance transports rose 22.2 percent, from $24,924 in 2017 to $30,446 in 2020. The average estimated allowed amount rose 60.8 percent, from $11,608 to $18,668. The average Medicare reimbursement rose 4.7 percent, from $3,570 to $3,739.

In Sisters, we have a choice of two subscription providers: Life Flight Network and AirMedCare Network. Life Flight Network, a nonprofit air medical transport service, has helicopter, fixed-wing, and ground ambulance bases throughout Oregon, Washington, Idaho, and Montana. Life Flight Network has administrative offices in Aurora, Oregon, and employs over 750 people.

AirMedCare boasts 3 million members with 320 locations in 38 states. They are a unit of Global Medical Response, Inc., a large, privately held, investor-owned enterprise based in Colorado. Premiums for the two range from $65 to $110 per year.

These are not part of a trip or travel insurance, an entirely different scenario. Life Flight and AirMedCare are meant primarily for year-round use near to where you live, although the AirMedCare plan will work in 38 states. Life Flight covers four states – Oregon, Washington, Idaho and Montana. Helicopters typically operate in a 175-mile range.

Change the scenario and let’s say you are vacationing in Costa Rica or even Canada and need an air ambulance. You will need to have purchased a higher-level trip insurance policy or an international air ambulance policy from one of dozens of commercial providers.

Let’s say you fall off the roof and live in Sisters. Or experience a stroke or heart attack. You call 911. Paramedics from Sisters-Camp Sherman Fire District respond. What happens next? Ninety-nine out of 100 times, you will end up at St. Charles, Bend, and on rare occasion, St. Charles may ask that the patient be diverted to Redmond.

Depending on severity a patient may request an alternate destination, say to a clinic or their doctor’s office. What does a ride in the ambulance cost? $1,500 plus $20/mile. In 2021 Sisters- Camp Sherman Fire EMS transported 509 patients by ground and six by air.

In some cases it will be an air transport regardless of insurance or patient desires. If it’s serious enough, truly life-threatening, 911 might dispatch a bird simultaneously with the ground unit: “A motor vehicle accident at Santiam Pass or a serious ski accident at Hoodoo would be good examples,” Chief Johnson said.

So, it’s unlikely you will ever be deprived of a lifesaving air ambulance. It’s merely a matter of how much you will pay.