State Offers Guidance On Air Ambulance

Braden Gunem

Air Ambulance has been a hot topic in the State of Wyoming over the past several years. After recent communications from air ambulance companies, we thought it important to share this information from the Wyoming Department of Insurance.

Air Ambulance Membership/By The Wyoming Department of Insurance

Insurance is an important feature of daily life, but it is also one of the least understood. This article is intended to provide some clarification, but it is only an overview. Specific insurance questions can be discussed with your agent, broker, or insurer. If you are Medicare eligible, you may contact Medicare or your Medicare Supplement insurer to discuss details about your insurance, including air ambulance coverage. Additionally, you are welcome to contact the Wyoming Department of Insurance at 307-777-7401. (Please understand that during the COVID19 pandemic, most of the Department of Insurance employees are working remotely so there may be some delay in responding to your questions.)

The mission of the Department of Insurance (DOI) is to provide consumer protection through licensing, financial examination, investigation and resolution of consumer complaints, and review of insurance plans and policies for compliance with state law. In order to fulfill its mission, the DOI has diverse responsibilities including licensing and regulating insurance companies; licensing and regulating agents, brokers, adjusters, and consultants; and monitoring the insurance products that are sold in Wyoming. As part of its regulatory responsibilities, the DOI reviews and approves policy filings, investigates consumer complaints; monitors the financial condition of insurance companies, and collects taxes on the premiums charged by insurance companies on policies sold to Wyoming citizens. These consumer protections also apply to air ambulance membership.

For most insurance transactions, Wyoming laws require insurance companies to be licensed before selling their products or services in Wyoming. Part of the licensing requirements for an insurance company includes providing information regarding the company’s accounting methods, procedures and financial solvency. This information is used by the DOI to ascertain whether the company is in good financial standing and able to pay claims in the event a claim is received. If the company meets the requirements of the Insurance Code, a Certificate of Authority is given to the company.

The insurance policy is the contract between a consumer and an insurance company. The insurance contract describes the insurance company’s obligations to pay for certain expenses, damages, or losses incurred by the consumer. Policies may also limit coverage for certain losses as exclusions to what is covered. The Insurance Code requires that certain provisions be included in policies, and prohibits other provisions. The DOI reviews the policies used by insurance companies to ensure that they comply with the Wyoming Insurance Code.

A recent change to Wyoming Statute 26-5-103(a)(ii), changed the definition of disability insurance under the Insurance Code. The change to Wyoming Statute 26-5-103(a)(ii) states that disability insurance is now defined as “insurance of any kind on human beings against Disablement or expense resulting from sickness, including subscription or membership plans relating to air ambulance transport services.” [Italics included as in the codified statutory provision and bold added for clarity.] The change to the statute was made during the 2019 Legislature, but the effective date of the new definition of disability insurance was delayed until April 1, 2020. This delay in the effective date provided time for companies selling air ambulance subscriptions to make the necessary changes to comply with the statutory change.

Since the DOI regulates insurance, including all disability insurance, all air ambulance memberships and subscriptions are now treated like all other disability insurance products. All other disability insurance products must be sold by licensed insurance companies, and those companies must meet all the requirements applicable to insurance companies contained in the Wyoming Insurance Code.

Companies selling air ambulance memberships and subscriptions must show that they are financially solvent so they can pay claims when a claim occurs, and they must file their policies with the DOI so the DOI can ensure the policies comply with Wyoming law. This statutory change also gave the DOI the ability to investigate complaints against the company, and to make sure that the company conducts itself in compliance with the various consumer protections contained in the Insurance Code. If the company does not comply with the Insurance Code, the DOI now has the ability to enforce compliance through an administrative action which could result in imposition of civil penalties, revocation of the company’s license to sell memberships and subscriptions, or both.

Recently, there has been considerable information distributed regarding the effect of this new legislation, some of which is inaccurate. For example, some consumers have been told that Medicare does not provide for air ambulance transport coverage. However, air ambulance transport is covered by Medicare if the service is medically necessary. In other words, the air transport can’t be merely for the convenience of the patient. Secondly, the air transport will be to the closest medical facility that has the capability to treat the underlying medical condition. Unfortunately, not all hospitals in Wyoming have the needed medical staff, equipment, or expertise to treat all underlying medical conditions. As a result, it may become necessary to transport a patient to a larger medical facility within or outside of Wyoming to provide the needed care.

Some consumers have also been told that air ambulance memberships are not allowed to be sold in Wyoming under this new statute. However, air ambulance memberships can still be sold in Wyoming, but the company selling these products must now be licensed. Air Methods has ended its membership program and will be sending letters to Wyoming citizens regarding refunds of their membership premiums if they already had coverage through Medicare. Additional information about the Air Methods program can be found at: https://www.jems.com/2019/11/25/air-methods-ends-membership-program/ or at:

https://www.airmethods.com/newsroom/2019/11/18/air-methods-to-refund-medicare-patients-as-part-of-no-membership-required-program

We understand this is a complicated issue. Please rest assured that if you need air ambulance transport services today, air ambulance aircraft are still flying and providing excellent service to the people of Wyoming. Air ambulance memberships can still be sold, but only by licensed companies. The license requirement is there to provide consumer protections for Wyoming consumers.

For additional questions, please contact your insurer, Medicare supplement provider, AARP, WySHIIP, or the Wyoming Department of Insurance. Or, go to the websites for each of these organizations.

AARP.ORG/Wyo

WySHIIP: www.wyomingseniorcitizens.com;

1-800-856-4398____________

Dept. of Insurance: DOI.wyo.gov;

1-307-777-7401