Covid-19 has landed many people in a life-or-death situation and in need of urgent medical attention.
One of the first points of assistance that many need is the ambulance. But have you ever stopped to think about the cost of using the emergency vehicle?
Personal finance website JustMoney, investigated how much an ambulance trip costs in South Africa, whether you can refuse to enter an ambulance, and who pays the bill if you’re unconscious when an ambulance is called.
Depending on what service you need in an ambulance, you can expect to pay anything from R4 000.
Shafeeka Anthony, JustMoney marketing manager, said: “The Covid-19 pandemic has made us far more aware of the possibility of needing health services in a hurry. Having proper medical cover in place is essential, and it’s well worthwhile educating yourself on the schemes available, and heeding advice to ensure you have the right cover for your needs.”
This price list distinguishes between three kinds of emergency life support: basic, intermediate and advanced. All three are interventions used to stabilise patients until they reach a hospital. Depending on the state of a patient, emergency personnel will perform the necessary life support to ensure their safety.
The main difference between basic and advanced life support is that the former does not include invasive treatments – in other words, a patient’s skin will not be pierced, such as with a needle or a scalpel, if they receive basic life support.
The patient will be billed according to the category their life support falls under. For example, if your lung collapses in an ambulance, and emergency personnel need to puncture your chest to re-inflate it, this will be considered advanced life support because your skin had to be pierced.
All emergency medical service providers invoice the medical scheme if the patient is insured, or the patient directly if they do not have medical insurance cover, says Shalen Ramduth, director of operations at Netcare 911.
How does the billing work?
In South Africa, medical aid providers have partnered with specific private emergency companies, outsourcing them to clients to call in an emergency. If patients call a different company, insurers only pay 40-60% of the account.
If you were unconscious when the call was made, the insurer will assume that someone else called and the full account will be covered. But this must be motivated for by the transporting ambulance service, who will need to advise why the client didn’t follow the correct procedure.
Denver Ramnarain, director of Quick Response Services, points out that ambulances are not financial institutions and, as such, they cannot offer patients credit. Patients often say they either can’t pay anything, or they didn’t call the service, and so refuse to pay, says Ramnarain.
However, a person may refuse medical help. But Ramduth says that all emergency medical service providers should assist with life-threatening cases, even where patients cannot pay for the treatment received.
If they decide to wait longer than necessary and not transport a person with life-threatening injuries, this could be considered neglect, which can be reported to the Health Professions Council of South Africa.
“However, this is hard to prove as the person may decide that they don’t want treatment and may not disclose that it is due to cost. Or the medic may be acting in the best interest of the patient and they could still die,” says Ramnarain.
According to the Western Cape government’s website, no one will be refused emergency medical services based on their ability to pay for the service.
It states that if you’re a member of a specific medical aid, you’ll be charged uniform patient fee rates agreed with the medical aids. And if you’re not, you’ll be assessed according to your income, and charged accordingly.