The cost of an ambulance ride in Ridgefield is going up.
A basic ambulance ride went from $606 to $682 and the most expensive ambulance services, Advanced Life Support-2, have gone from $991 to $1,115 — although the bulk of the cost of taking an ambulance is usually covered by Medicare, Medicaid or private insurance. The middle level, Advanced Life Support-1, increased from $960 to $1,080. And the additional “per mile” charge increased from $14.76 to $16.61 on any ambulance ride.
The Ridgefield Fire Department provides about 2,000 ambulance rides a year. There were 2,103 ambulance calls in 2014, representing 64% of the fire department’s work, and 2,182 ambulance calls in 2013, making up 65% of department activity.
The new prices come as the result of a 12.5% across-the-board ambulance fee increase approved by the Board of Selectmen on Wednesday, Dec. 9.
Maximums for ambulance rate increases are set for towns by the state, and this year’s was initially 2.5%, which is in line with the annual fee hikes in other recent years — 3.4% in 2015, 4.1% in 2014, 2.9% in 2013. But in dealing with Connecticut’s budget problems, state support for local ambulance services was cut by 10%, and the state followed that with a new ruling that allowed EMS services to recover the lost revenue with an additional increase of up to 10%.
“They’re cutting, cutting, and throwing the burden onto municipalities,” First Selectman Rudy Marconi said of the state.
The 2.5% and 10% increases together make up the 12.5% approved by the selectmen.
Even with the state reimbursement and the fees charged for services, the town’s ambulance-related revenue comes nowhere near covering the cost of providing the service.
Controller Kevin Redmond told the selectmen that the ambulance service cost the town about $2.4 million a year but brought in only about $700,000 a year in revenue.
The selectmen hiked the ambulance rates with the belief that government health insurance programs and private insurance companies would bear the brunt of the increase, and most people — and certainly those most financially vulnerable — wouldn’t be affected.
“It’s not going to impact your seniors on Medicare, it’s not going to impact your low-income on Medicaid,” said Tonie Gentile of Certified Ambulance Group, the firm that collects ambulance bill payments for Ridgefield and many other towns.
The federal government also sets a maximum that can be billed for an ambulance ride under Medicare, so seniors’ bills would be capped at $465.90 and Medicare would pay 80% of that, or $365.27, and for the remaining 20% many seniors have some kind of additional Medicare “gap” coverage — such as is available through AARP — that would take care of it.
For seniors with low incomes and no gap coverage, the town may provide further help with ambulance bills.
“The most they’d be responsible for is $100, and we do make assistance available through Social Services,” Marconi said.
For people who aren’t seniors but qualify as low income and are on Medicaid, the maximum allowable charge for an ambulance ride is $317, and Medicaid pays all of that.
All the town officials at the meeting made a point of saying that concerns about cost should never cause a senior — or anyone else — to hesitate over calling an ambulance when they think emergency medical help is needed.
The first selectman posed a question to Gentile, of the ambulance billing agency.
“If it’s not paid, do we get aggressive?” Marconi asked.
“The town does not allow us to do so,” she replied.
The motion for the 12.5% increase was made by Selectman Steve Zemo, and passed unanimously.
“We’re encouraging people to see Social Services if they have problems in the family budget,” Zemo said.
According to Assistant Fire Chief Jerry Myers and Gentile, 62% of Ridgefield’s EMS patients are on federal medical programs — 58% seniors on Medicare, and 3% are low-income people on Medicaid — while 24% have private insurance, 13% are “self-pay,” and 1% are covered by either automobile insurance or workers’ compensation.
Advanced Life Support services — which went up to $1,080 to $1,115 for the two levels — are generally services that require a paramedic to provide them and are administered to patients in serious or life-threatening situations, such as heart attacks. They include cardiac medications, electric defibrillation to restart a heart, and medication for seizures, according to Myers. Basic ambulance service, now $682, is the charge in situations that require only first aid-type care and a ride to the hospital, as for a sprained ankle, he said.
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