NCL calls on insurers to cover air medical services during COVID-19 crisis

May 5, 2020

Contact: National Consumers League – Carol McKay,, (412) 945-3242 or Taun Sterling,, (202) 207-2832

Washington, DC –The National Consumers League (NCL) last week sent a letter to the CEOs of Cigna, Aetna, and UnitedHealth Group, urging them to enter into productive negotiations with air medical service providers to ensure coverage of emergency air medical transportation. The ask comes as the COVID-19 pandemic spreads across the country, making air medical services even more essential, particularly in rural America.

In its letter, NCL notes that it is increasingly concerned about emergency air medical access during this crisis, and that it believes this life-saving care should be covered by every insurance plan. NCL asks that insurers review the robustness of their coverage policies and immediately to enter into network negotiations with air medical providers so that this critical service is covered, and patients are never left with a bill they cannot pay.

Text of the letter, signed by NCL Executive Director Sally Green is below:

Dear Mr. Wichmann, Mr. Cordani, and Ms. Lynch:

The National Consumers League has long advocated for health care as a right and argued for fair treatment for all stakeholders across the health care spectrum – patients, physicians, hospitals, health plans, and health care providers. Our mission is particularly acute during the global COVID-19 pandemic, when medical professionals are on the frontlines fighting for our health and safety, stricken patients need life-saving care, and nearly everyone is focused on their health and that of their loved ones.

In this vein, we are increasingly concerned about access to emergency medical care, especially in rural America, as the virus indiscriminately makes its way across the country. When minutes count, Americans who fall victim to COVID-19 must be assured that they can get to the nearest, most appropriate medical facility as quickly as possible. As COVID-19 strains hospital capacity and critical medical equipment like ventilators become attenuated, emergency air medical transports between facilities are often the only way for patients to get the care they need.

According to the Centers for Disease Control and Prevention (CDC), 85 million Americans can only reach a Level 1 or Level 2 trauma center within one hour if they are flown by an air medical helicopter. The effects of this access problem are staggering, and even more pronounced as we wrestle with the COVID-19 crisis. For many Americans, air medical ambulances are a vital link to timely, life-saving care.

We believe that such life-saving care should be covered by insurance. Patients pay their monthly premiums – and copays and deductibles – so they are not bankrupted should the worst befall them or their loved ones. Unfortunately, there have been far too many stories of people who were transported by air ambulance because it was ordered by a first responder or doctor, only to be told later by their insurance company that they would have to shoulder the bulk of the cost. This should not be the case anytime, but especially now as our nation wrestles with a pandemic.

This explains why we at the National Consumers League are writing to you for your input and thoughts. We believe that emergency air medical transportation should be included in every health coverage plan. We think that insurance companies and air medical providers must work together to bring these services in-network, so patients are not left footing a bill they can never hope to pay.  Adequate network agreements are imperative so that patients are not told – after the fact – that they were transported by an air ambulance that was not in-network. When an emergency happens, or worse yet, a pandemic strikes, patients are not choosing whether to take an air ambulance, let alone choosing a particular provider.  Similarly, coverage denials based on “medical necessity” should be the exception, not the rule, in light of the fact that patients are not a part of the decision-making process.

We ask that your companies immediately take a comprehensive look at your coverage policies for air medical services and the robustness of your provider networks. We urge you and the air ambulance community to enter into network negotiations, take patients out of the middle, find a middle ground on reimbursement that fairly compensates both sides, and ensure rural communities have access to air ambulance transports. Refusing to fairly negotiate is simply not an option in light of the current crisis. Entering into productive negotiations immediately will ensure that patients across the country have access to the medical care they need and that they are simultaneously protected from balance bills.

Thank you for your attention to our concerns.


Sally Greenberg
Executive Director
National Consumers League


About the National Consumers League

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