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Ground Ambulance Surprise Bills: A Costly Loophole in the No Surprises Act



The No Surprises Act (NSA), which was enacted in January 2022, provides landmark protections against surprise billing in a wide range of settings, including hospitals, ambulatory surgical centers, and air ambulances. However, ground ambulance transport is not covered by the NSA.

This means that consumers can still receive surprise bills for ground ambulance rides, even if they have health insurance. Surprise bills can occur when a patient receives a bill from a provider who is not in their insurance network, or when the provider charges more than the amount the insurance company is willing to pay.

The average cost of a ground ambulance ride in the United States is over $2,000, and surprise bills for ground ambulance rides can be even higher. This can be a financial burden for patients, especially those who are already dealing with medical expenses.

There are a few things that consumers can do to protect themselves from surprise bills for ground ambulance rides:


  • Check with your insurance company to see if they cover ground ambulance transport. If they do, ask them about your network of providers and how much coverage you have.

  • If you need to call an ambulance, ask the dispatcher if the ambulance company is in your insurance network. If it is not, you may be able to request an ambulance from a different company.

  • Get a cost estimate from the ambulance company before they transport you. This will help you to avoid any surprises when you receive the bill.

  • If you receive a surprise bill for a ground ambulance ride, contact your insurance company and the ambulance company to try to resolve the issue.


If you are unable to resolve the issue with your insurance company or the ambulance company, you may be able to file a complaint with your state's Department of Insurance.

If you have any concerns about the cost of ground ambulance transport, be sure to talk to your doctor or insurance company. They can help you to understand your coverage and how to protect yourself from surprise bills.

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