Air Ambulance Balance Bill Estimator

Balance surprise air ambulance invoices against what your insurer will actually pay. Supply the billed charge, the percentage your plan allows, and your coinsurance to reveal how much lands on you versus the plan. Optional fields account for remaining deductible, your out-of-pocket maximum, and any negotiated reduction of the balance bill so you can budget and plan appeals.

Total invoice from the air ambulance provider.
Percent of the bill your plan recognizes (enter 250 for 2.5× Medicare).
Share you owe on the allowed amount once the deductible is met.
Amount of deductible left before coinsurance applies.
Remaining cap on in-network medical spending; used to cap responsibility if entered.
Percent of the balance bill you expect to negotiate or have waived.

Reference only. Confirm final liability with your insurer, the air ambulance provider, and any applicable surprise billing protections.

Examples

  • $48,000 bill, plan allows 250%, 20% coinsurance, $1,500 deductible left, $6,000 out-of-pocket max, 40% balance reduction ⇒ Patient responsibility after caps: $6,000.00 USD • Plan payment on the claim: $54,000.00 USD • Balance-bill portion after negotiation: $14,400.00 USD (30.00%) • Coinsurance collected: $5,400.00 USD • Deductible applied: $1,500.00 USD • Patient share vs. billed charge: 12.50% Out-of-pocket max reached; plan assumes an additional $10,800.00 USD.
  • $32,500 bill, plan allows 300%, 10% coinsurance, deductible cleared, no OOP cap entered, balance reduction blank ⇒ Patient responsibility after caps: $11,050.00 USD • Plan payment on the claim: $86,450.00 USD • Balance-bill portion after negotiation: $21,750.00 USD (66.92%) • Coinsurance collected: $6,500.00 USD • Deductible applied: $0.00 USD • Patient share vs. billed charge: 34.00%

FAQ

Does this assume No Surprises Act protections?

Only if you enter an out-of-pocket maximum. Without that cap, the calculator shows worst-case exposure when a claim falls completely outside NSA arbitration.

How should I estimate the allowed percentage?

Use the plan’s disclosure, past air or ground ambulance claims, or a multiple of Medicare rates supplied by your insurer. Many carriers default to 200%–325% of Medicare for negotiation.

Can I add state air ambulance caps?

Yes. Reduce the billed charge to the statutory maximum before running the calculation so the balance bill reflects your state’s limits.

What if the provider bills a separate mileage fee?

Include it in the billed charge so both the base lift-off fee and per-mile add-ons are reflected in the allowed amount and potential balance bill.

Additional Information

  • Many employer plans cap air ambulance allowances at 200%–400% of Medicare; any amount above that becomes balance-bill exposure unless state or federal surprise billing protections apply.
  • Negotiation percentages reflect provider write-offs, single-case agreements, or patient-advocate wins; leave it at 0% if you have not negotiated yet.
  • Out-of-pocket maximums only apply to in-network benefits. Use the optional cap to model good-faith payments when your plan voluntarily treats the claim as in-network under the No Surprises Act.

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