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Life & Health Insurance/Ambulance service under health insurance


QUESTION: I assume different policies have different coverage levels for a 911 call that sends an emergency vehicle.  And another wrinkle to understanding how this works in my town/county (in Florida) is that there are both private ambulance services and the town fire and rescue department.  This is probably too localized for you to give more insight, but on the chance that you have such knowledge, I'm simply trying to understand the whole issue.


I'm on the first day of a five day business trip, so it may be a day or two before my next reply.

That said, the answer to your question depends more upon whether we're talking about an Affordable Care Act (ACA) plan, or a policy sold before March 23rd, 2010, aka Grandfathered or Grandmothered policies.

Typically though, if it is a life-threatening emergency, the insurer is not allowed to penalize you for non-contracted/out of network services received. Once stabilized, they may require you to receive follow-up care in-network. It should not matter whether a county EMT or private ambulance was involved.

If you could give me a little more information on what has transpired, I may be able to give a more specific answer.

Thank you.

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QUESTION: Thanks.  Actually, the question is not about anything that happened.  This is just curiosity because sometimes employees ask me about different points related to their policy.  But we do have the Grandfathered plans from Blue Cross.  Here in Clay County, Florida, I often see both town emergency services trucks and private ER trucks here and there flashing lights and on their way to the hospital, so I just wonder about how both the 911 and the insurance works.


As mentioned, I'm on the road, and apologize for the delayed response.
On Monday I'll call BCBSFL agent support and get an answer. It's an interesting question, and I am interested in how they handle these situations there. In AZ and RI I know how these types of claims are processed, but obviously that is of little help to you.

On Monday we'll both learn something, hopefully.

Thanks again,

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Michael Higgins


All questions pertaining to health insurance, whether group, individual/family, student, child-only, COBRA, HIPAA, Portability, dental. No expert knowledge in areas such as life insurance, disability, workman's compensation, auto, etc.


34 years as owner of health insurance agency, primarily dealing with Blue Cross Blue Shield of Arizona.

College, Business Administration.

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