Kaiser Permanente does not operate its own air ambulance service; therefore, medical flights, either domestic or international  are conducted  by third-party providers, such as Aeromed.

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Call us immediately to verify eligibility an benefits, must transports will take place within the next 12 hours once benefits are established.Most Members have some level of air ambulance coverage.

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Our 24/7 Care coordinators will establish coverage and benefits within one hour of your initial call.

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Note for people with Medicaid: Kaiser Permanente Medicaid members are not covered for care outside the U.S. If you have one of these plans and are planning to travel internationally, you may want to consider purchasing our air ambulance membership for extra health coverage.

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Air Ambulance cost can vary significantly based on flight distance, provider location, and your insurance coverage.

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In the absence of insurance, costs can be extremely high, potentially ranging from tens of thousands to hundreds of thousands of dollars for a single flight.

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It is imperative that you contact us immediately to evaluate your insurance coverage. We will review your policy to clarify your specific benefits related to air ambulance services and your out of pocket expenses, if any.

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Factors influencing costs include:

• Distance:Generally, longer distances result higher expenses.

• Provider:Different air ambulance companies have varying pricing structures Aeromed aims to maintain competitive rates and minimize out-of-pocket costs.

• Insurance Coverage:  For Kaiser Permanente patients: We encourage you to contact us immediately. Our insurance specialists will review your plan and clarify the terms regarding air transport, as coverage can differ. We will submit a comprehensive bill for air ambulance servicesand diligently follow up with the Kaiser Permanente Plan until the claim is resolved.

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UTILIZATION GUIDELINES

I. Procedure: Ground and Air Ambulance and Non-Emergency Medical Transportation

A. Kaiser Permanente covers emergency ambulance, ground, air, and water transport services.
Coverage for ambulance transport is limited to medically necessary ambulance transportation
services and supplies of a licensed ground or air ambulance, when the member’s medical condition
requires basic life support (BLS), advanced life support (ALS), or critical care life support
capabilities of an ambulance to a hospital facility or inter-hospital facilities.

1. Coverage is also provided for emergent, medically necessary transportation due to a 911 call.
2. Ambulance services are covered only within the Kaiser service area except those covered
under the emergency service provision specified in each contract.

II. Clinical Guidelines for Ground Ambulance

A. Emergency Ambulance Transport Medical Necessity
An Ambulance transport is clinically indicated when there is an emergency medical circumstance such
that the use of any other method of transportation is contraindicated and would endanger the
member’s health, as attributed to any of the following:
1. Needs to be transported in an emergency, such as an accident, injury, or acute illness, or
2. Needs to be restrained to prevent injury to themselves or others; or
3. Is unconscious or in shock; or
a. Requires high flow rate oxygen of 2 liters or more or other emergency treatment which is not
available during other types of transport to the nearest appropriate facility; or
b. Exhibits signs and symptoms of acute respiratory distress or cardiac distress such as shortness of breath or chest pain; or

c. Exhibits signs and symptoms that indicate the possibility of acute stroke; or

d. Needs to remain immobile because of a fracture that had not been set, or manifesting signsand symptoms of a potential fracture and /or dislocation; or

e. Is experiencing severe hemorrhage; or

f. When a member requires care at an alternate acute care Medical Facility, including further care coordination, as determined by the treating provider.

 

B. Non-Emergency Ambulance Transport
A non- emergency ground ambulance transport is medically necessary when the member is to be
transported from the hospital to any of the following destinations and purposes:

1. Skilled Nursing facility (SNF) or acute rehabilitation facility for the purpose of admission; or
2. Another hospital when the facility cannot adequately care for the member, needs a higher level
of care, or needs to be transported to an affiliated or Core facility; or
3. A free-standing facility or provider to obtain medically necessary diagnostic or therapeutic
services not provided by the hospital; or
4. A Kaiser Permanente medical facility for ongoing care, if the patient is determined to be stable for hospital
discharge per the treating physician; or
5. Members’ home if ambulance transport is medically indicated.

III. Clinical Guidelines for Non-Emergency Medical Transport (i.e., Ambulette, Paratransit)

Services for Non-Emergency Medical Transport (NEMT) modalities, such as “Ambulettes,” which are not
licensed as ambulances, are considered medically necessary when there is an established need to
transport members for continuance of care and to improve the coordinated delivery of care. Licensed
and contracted NEMTs are indicated when only a safe mode of transportation is needed to provide
ongoing, coordinated care and when the treating provider determines that the full clinical support of a
BLS ambulance is not necessary during transport.
A safe mode of transportation is defined as a transportation modality for those members requiring direct
assistance with mobility from their point of origin to their destination. They must be unable to ride in a
standard vehicle without assistance and require help by at least one person to get to the vehicle, into the
vehicle, out of the vehicle or to their destination. They must be able to sit upright, assist the transporter
with transfers if needed and not require any medical intervention during transport.

The medical necessity of a non-ambulance transport is established when the member meets any of the
following originations and purposes:

A. From Hospital:
1. For discharges from the hospital to a SNF, when medical monitoring and medical care is not
needed; or
2. To a Kaiser Permanente Medical Center or another ambulatory care provider for members unable to be
safely transported by private or public transportation.
B. From Skilled Nursing Facility or Acute Rehab to:
1. Hospital for the purpose of non-emergency admission, evaluation, or testing; or
2. Outside provider, including a KP medical center, to obtain medically necessary diagnostic
or therapeutic services not provided by the SNF or acute Rehab; or
3. Another SNF or Acute Rehab when the facility cannot adequately care for the member; or
4. An external dialysis facility, if only safe transport is needed; or
5. Members’ home, if only safe transport is needed.
C. From a KP Medical Center for safe transport when no medical observation or care is needed
during transport:
1. Hospital for the purpose of non-emergency inpatient admission; or
2. SNF for the purpose of admission; or
3. A KP medical center for continuity and coordination of ongoing medical care when
services are not available at the sending KP medical center; or
4. A KP Medical Imaging Center(s), for imaging not available at the sending KP office or
medical center; or
5. Member’s home if transport is indicated for safety
D. From home to the following outpatient care facilities, if the member cannot be safely
transported by self, family or care givers, or public transportation.
1. A stand-alone dialysis facility, if transport is for special, short-term circumstances when
member has no other safe transport options; or
2. A facility for medical care, including a KP Medical Center, if member is unable to be safely
transported by private or public transportation.

IV. Exclusions and Limitations for Ground Ambulance and Non-Medical Transport
A. Ambulance transportation is NOT indicated for:

1. Dialysis or oncology treatments for members who do not need medical care or monitoring
during transportation; or
2. Transportation from one custodial care facility to another; or
3. Transportation from or to the physician’s office for routine services; or
4. Transportation from or to a member’s home and a custodial care facility; or
5. Ambulance transport from a hospital capable of treating the member to another hospital
because the member or the member’s family prefers a specific hospital or physician.
 

B. Exclusions for both Ground Ambulance and Non-Emergency Medical Transportation

Any request for non-emergency medical transport that does not meet the medical necessity or
coordination of care requirements are not covered.

V. Clinical Guidelines for Air Ambulance
Emergency air transport is clinically indicated when the member’s condition is such that the time needed
to transport a member by ground, or the instability of transportation by ground, poses a threat to the
member’s survival or seriously endangers the member’s health.

 

1 Air ambulance transportation services,
either by means of a helicopter or fixed wing aircraft, is medically necessary on any the following:

A. Community to Hospital Air Transport
An air transport from the community to a hospital is clinically indicated if all of the following criteria
are met:
1. When the member’s medical condition requires immediate and rapid ambulance transportation
that cannot be provided by ground ambulance due to either of the following:
a. The point of pickup is inaccessible by ground vehicle (this condition could be met in Hawaii,
Alaska, and in other remote or sparsely populated areas of the continental United States); or
b. Great distances or other obstacles prevent the timely transport of the member to the
nearest hospital with appropriate facilities; and
2. The member must be alive at the time of the air ambulance’s departure from their origination site
except when a member is pronounced dead before being loaded onto the ambulance for
transport (either before or after the ambulance arrives on the scene) and meets all of the
following:
a. The air ambulance service would otherwise have been medically necessary; and
b. The pronouncement of death is made by an individual authorized under state law to make
such pronouncements.
3. As a general guideline, air transportation is appropriate when ground ambulance is predicted to
exceed 30-60 minutes to transport a member whose medical condition requires immediate and
rapid transport due to the nature and/or severity of the illness/injury. However, differing
statewide Emergency Medical Services (EMS) systems determine the amount and level of basic
and advanced life support ground transportation available. and
4. The aircraft and crew must meet the ambulance requirements listed in Sections V, VI and VII.
Ambulance Vehicle and Crew Requirements; and
5. All cardiac air ambulance transports require the review and authorization of the on-duty 
Emergency Care Management (ECM) Physician. Cardiac conditions, requiring medically
necessary urgent/emergent air transport services can be authorized by referring Physicians in
conjunction with Cardiologists.

B. Hospital to Hospital Air Transport
An air ambulance transport from one hospital to another hospital is clinically indicated if all of the
following criteria are met:
1. If transportation by ground ambulance would endanger the member’s health and the
transferring hospital does not have adequate facilities to provide the medical services needed
by the member; and
2. If the hospital to which the member is transferred is the nearest one with appropriate facilities
or is a contracted hospital for special services.
a. Examples of specialized medical services not available at all facilities may include but not
limited to burn care, cardiac care, neurosurgical care, neurointerventional care, trauma
care, and critical care.

VI. Exclusions / Requirements for Air Ambulance
An air ambulance transport is considered NOT medically necessary in the presence of any of the
following:
A. When the air ambulance dispatcher is notified of the member’s death and there was a reasonable
opportunity to notify the pilot to abort the flight. This includes when an air ambulance has been
cleared for takeoff or taxied but has not actually lifted off; or
B. Services that are considered non-critical care. Air transport services are not covered for transport
to a facility that is not an acute care hospital, such as a nursing facility, physician’s office, or a
member’s home; or
C. When the air ambulance transport is from a hospital capable of treating the member to another
hospital because the member or the member’s family prefer a specific hospital or physician; or
D. Cardiac conditions without cardiogenic shock require review and authorization by a physician
provider. 

VII. Air and Ground Ambulance Vehicle and Crew Requirements
Ambulance  transport must comply with all of the following requirements:

A. Any vehicle or aircraft used as an ambulance must be designed and equipped to respond to
medical emergencies and, in non-emergency situations, be capable of transporting members with
acute medical conditions; and

B. The vehicle or aircraft must comply with state or local laws governing the licensing and certification
of an emergency medical transportation vehicle; and

C. Basic Life Support (BLS) ambulances must be staffed by at least two people, at least one of whom
must be certified as an emergency medical technician (EMT) by the State or local authority where
the services are being furnished and be legally authorized to operate all lifesaving and life
sustaining equipment on board the vehicle; or

D. Advanced Life Support (ALS) vehicles must be staffed by at least two people, at least one of whom
must be certified by the State or local authority as an EMT-Intermediate or an EMT-Paramedic.

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