North Dakota Insurance Department Publishes Air Ambulance Guide

August 1, 2017

The North Dakota Insurance Department has released a guide showing which air ambulance companies operating in North Dakota have contractual agreements (in-network) with the state’s three major health insurance companies – Blue Cross Blue Shield of North Dakota, Sanford Health Plan and Medica.

The release of the guide follows the April signing of Senate Bill 2231, regarding the regulation of how insurance companies pay for air ambulance services in North Dakota. The bill also requires that beginning Aug. 1 hospitals notify patients in non-emergency situations of the network status of air ambulance companies with the patient’s health insurance provider.

Air ambulance has become a more frequently used mode of transport for individuals needing medical care, even in non-emergency situations. Despite a patient having health insurance, often times they are then faced with large, unexpected bills for the full cost of the flight or the balance left after a partial payment is made by the patient’s insurance company, a practice known as “balance billing.”

Insurance does not cover the full cost of an air ambulance when the ambulance provider does not have a contract with the patient’s health plan.

From 2013 through July 2017, the Department has received 32 complaints totaling $1.77 million in charges for air ambulance services. Based upon these complaints, each air ambulance ride has costed the consumer $55,341 on average. Consumers in North Dakota have reported being billed amounts ranging from $18-$83,613. However, these numbers don’t include the hundreds of complaints that have been made directly to insurance companies regarding air ambulance services.

The Air Ambulance Participation Guide can be found at

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