MDA has initiated a revolution in payments for ambulance transport. To this day, every patient evacuated to the hospital received their payment obligation at the emergency room, which led to many forgetting about their payment obligation altogether and not handling it with their health insurance, national insurance, the IDF, or pay for it themselves in case their insurance did not cover it.

Starting September 1st, MDA will revolutionize the current system and patients will no longer receive their payment obligation form in the hospital in order to prevent confusion, loss of the form and lack of clarity. The payment obligation will be issued by MDA immediately upon the patient’s evacuation, members of Clalit and Maccabi health insurance will enjoy the new order in which MDA will handle the payment directly with their healthcare provider, without the patient having to deal with it at all.

In case the patient’s health insurance company finds that the patient is not eligible for coverage of the evacuation cost, MDA will pass the payment obligation form to the patient with an explanation of the process. It should be clarified that at this point, the new order only applies to the Clalit and Maccabi health insurance companies, in which 85% of the Israeli population is ensured.

Members of the Leumit and Meuchedet insurance companies will receive the payment obligation form in the mail several days following the evacuation and will be required to pass the form to their insurance company. MDA is currently operating towards signing another contract so that customers of the two other companies, Leumit and Meuchedet, will also be able to enjoy the new order.

IDF soldiers are eligible for full coverage of the evacuation cost by the IDF, and MDA will handle the payment process without involvement of the soldier. MDA would like to reinforce that in case of treatment on the scene without evacuation to a hospital, the payment obligation applies to the patient and the form will be mailed to his or her address several days later.

Below is MDA’s Payment Guide:

Members of the Clalit and Maccabi insurance companies (85% percent of the population): the payment obligation form will be transferred directly to MDA by the health insurance company, both parties will check the patient’s eligibility for a coverage of the transport cost. In case the patient in eligible for full coverage of the evacuation cost, the insurance company will transfer the payment to MDA without the patient’s involvement. In case the patient is not eligible for a coverage of the cost, MDA will mail a letter to the patient’s address, clarify to the patient that the health insurance company will not cover the transport cost and ask the patient to cover it himself or herself. In case the patient is eligible for partial coverage, the patient will receive a letter from MDA regarding the fraction of the cost that has to be paid for by him or her, as well as the deadline by which it must be paid.

Members of Leumit and Meuchedet insurance companies: the transportation payment form will not be handed to the patient at the ER, but will be sent to the patient’s home address several days following the transport to a hospital. The patient must transfer the form to the health insurance company and find out whether he or she are eligibility for coverage of the cost. If the patient is eligible for full coverage, MDA will handle the process with the insurance company without the involvement of the patient. If the patient is eligible for partial coverage of the cost, the patient must handle the process with MDA. If the patient isn’t available for any coverage of the evacuation cost, they must also handle the process directly with MDA.

MDA is expected to sign a contract with the two, aforementioned health insurance companies, in purpose of making the payment process similar to that of Maccabi and Clalit.

The following are cases in which the patient evacuated is eligible for full coverage of the evacuation cost by the health insurance company:

• Public loss of consciousness – the patient is eligible for full coverage by the health insurance provider.
• A woman in labor who gives birth within 72 hours of the transport – eligible for full coverage of the transport cost by national insurance. In case the woman was admitted to the hospital and did not give birth within 72 hours, she will be eligible for health insurance coverage of her transport cost. In both cases, MDA will handle the payment directly with the insurance company.
• Work accidents – the patient is eligible for full coverage of the ambulance by their health insurance even if he or she are not admitted to the hospital following the transport.
• Traffic accidents – the patient is eligible for full insurance coverage, even in case he or she are not admitted to the hospital. In case the patient is admitted to the hospital, the health insurance company will cover transportation costs. In case the patient is evacuated from the scene of the accident in a mobile intensive care unit but is not admitted to the hospital, the trip is free of charge. In case the patient is transported in a ‘regular’ ambulance, but is not admitted to the hospital, the cost will be covered by their health insurance.
• IDF soldiers – the IDF will cover evacuation charges, which will be handled directly between MDA and the IDF, without the soldier’s involvement.
• Deaths – in case MDA teams conduct resuscitation on the field, the dead’s family will receive a full refund of charges from their health insurance. In case resuscitation isn’t conducted, for whatever reason, the dead’s family will receive their payment obligation in the mail and handle it directly with MDA.

(YWN – Israel Desk, Jerusalem)