CHARLOTTE, N.C. (WBTV) – Angie Pannone says cost was the last thing on her mind when her loved one was put in the back of an ambulance last year.
“You’re assuming when you have insurance that it’s going to be covered,” Pannone told WBTV.
Her assumption was wrong.
Pannone received a bill in the mail from Medic charging her $980 dollars — that’s after health insurance agency MedCost paid about $790 dollars of the $1,774 bill.
“I thought, there’s no way that this could be accurate,” Pannone said.
So she contacted Medic — the emergency medical services provider for the Charlotte area.
“They explained to me that my health insurance was not in network with them, and that I was being billed out of network and would be responsible for the cost of the balance,” Pannone said.
That’s when Pannone contacted MedCost, but she says MedCost pointed the finger back at Medic.
“[MedCost was] saying that it should be covered, where Medic was saying, ‘No, it’s not going to be covered.’ And so it was just sort of a battle between two different companies,” Pannone said. “That’s when I called you.”
WBTV contacted Medic to determine what was going on.
In a statement, a spokesperson for Medic said Pannone’s experience is also a widespread issue for EMS.
“Many commercial health insurance payors choose to reduce charges to a rate they are willing to pay, leaving the patient responsible for the balance. This is an issue for EMS nationwide, as we are often not fully reimbursed for our services and are left to try and collect residual payment from the patient. Most people do not understand this about their health insurance coverage.”
Medic spokesperson
WBTV also contacted her insurer, MedCost.
Pannone says after WBTV contacted both companies, MedCost contacted her and said her bill would be paid in full.
“I did get a phone call immediately the next day, advising me that my bill would be paid in full, which was a very nice surprise,” Pannone said. “[I] was not expecting that after literally a year of fighting back and forth.”
Pannone is far from the only person to find herself in a situation like this.
State rep. hopes bill will help
According to a recent study published in the healthcare journal Health Affairs, patients are left with $129 million in potential surprise ambulance bills each year.
It’s why North Carolina Representative Donnie Loftis of Gaston County sponsored House Bill 489. It would require insurers to cover ground ambulance rides as in-network, and patients would pay no more than $100 per ride.
“I know personally people who have decided to drive themselves to the hospital because they’re aware of the high charges that goes with an ambulance transport,” said Rep. Loftis, who represents District 109 in Gaston County.
With this bill, Loftis hopes North Carolinians would be able to call 911 worry-free, and companies like Medic could be paid without having to garnish wages from a patient.
“Every time you crank that ambulance, there’s a cost involved,” Loftis said. “So, I’m trying to help it help recoup a consistent fee across North Carolina.”
As it’s written, the bill would require insurance companies to pay the locally approved rate for an ambulance ride or if there is no local rate, a minimum of either 400% of the Medicare rate or the provider’s billed charge— whichever is less.
While Pannone finally had her bill paid, she’s hopeful lawmakers can prevent this from happening to anyone else.
“It’s a lot of money for myself and for anyone it’s a lot of money,” Pannone said.
House Bill 489 passed the state House and was awaiting action from the Senate.
A spokesperson for Medic told WBTV that the agency is in favor of the bill.
