In regard to the editorial headlined, “Plane crash raises questions about emergency charges” (Review, Aug. 28), there are some important things to know about charges for emergency medical services in San Mateo County. We do not want any reader or member of the public to hesitate in calling 911 to obtain emergency medical assistance when needed.

Ambulance services provided under contract by American Medical Response are funded entirely on a fee-for-service model. That is, there is no taxpayer cost or county general fund support for these services. Residents and visitors who receive 911 emergency ambulance service from AMR only pay for those services when they actually receive them. 

In the overwhelming majority of cases, these costs are covered by insurance companies. Copays and deductibles are charged per insurance policy stipulations.

Medi-Cal patients, for example, pay no costs for ambulance service in response to a condition that requires immediate medical attention in San Mateo County. Private insurers set their own reimbursement rates. The county’s contract also mandates that AMR adhere to a Compassionate Care Policy for patients who do not have medical insurance and who have limited financial capacity. The policy extends discounts to patients who are at or below 250 percent of federal poverty level standards and ineligible for Medi-Cal/Medicaid or other third-party coverage, as well as for extenuating circumstances. 

AMR’s base rates and other charges also include pass-through funding to support other aspects of the overall 911 response to a medical emergency. Some of these funds, for example, are passed on to local fire departments to support their participation in the delivery of advanced life support care. Firefighters, who are also trained as paramedics respond with AMR and are often first to arrive at the scene of a car accident and treat victims while an ambulance is en route. 

AMR is required to have ambulance personnel and equipment continuously ready to respond at a moment’s notice throughout San Mateo County. The fee-for-service model ensures that San Mateo County maintains a robust emergency medical services system that effectively delivers life-saving care and service to those in need. 

— Travis Kusman, MPH, paramedic, associate director for Emergency Medical Services San Mateo County Health Department

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