UPDATE: A spokesman for American Medical Response says Cole should never have been billed for the ambulance and is in the process of notifying her.
YUBA CITY — Many remember the Oroville Dam emergency back in 2017 when 180,000 people were evacuated from their homes, assuming the dam’s emergency spillway would fail.
When nearly 200,000 people had to be evacuated for fear of massive flooding, 93-year-old Mildred Cole was put into an ambulance and driven 47 miles to Sacramento.
“They just put me in a wheelchair and wheeled me out,” Cole told FOX40.
Cole was rehabbing a leg injury at the Fountains Nursing Facility in Yuba City. The entire place was evacuated.
“We were sent to different locations because you couldn’t find places for people like us,” Cole said.
“At that point, with the threat of a flood, I was actually relieved that they were going to put her somewhere,” said Cole’s granddaughter and caretaker, Heather Terpelle.
That relief eventually faded when Terpelle got a bill for that ambulance ride for $792. A bill, Terpelle says, her grandmother can’t afford and Medicare wouldn’t cover.
“It seemed pretty clear to me that they had codes for special circumstances like an emergency evacuation,” Terpelle said. “I just assumed that the situation was an emergency. I mean it’s not like she could’ve called an Uber or something.”
Terpelle says she first saw the bill in November. One month later, she called the ambulance service, American Medical Response based in Sacramento, thinking it was a mistake.
She says they assured her it wasn’t. They classified the ride as disaster relief, a distinction that Medicare uses for specific claims for certain natural disasters. Yet, Terpelle says still she was told Medicare would not cover the ambulance ride.
In early 2018, Terpelle says she reached out directly to Medicare representatives. She claims she was told her grandmother could have been charged up to $2,500 for the ambulance ride.
“I was pretty disappointed with the attitude of the person that I spoke to,” Terpelle said. “I mean, he basically had the approach like it’s sort of duh, it’s going to be denied. It wasn’t a medical emergency.”
So, just this week, Terpelle says she filed an appeal directly to Medicare.
“I feel for other people in [my grandmother’s] situation that don’t have a family member or someone close to them to help advocate for them. It’s been a struggle, I’ve spent hours on the phone,” Terpelle told FOX40.
According to the Centers for Medicare and Medicaid Services, there are certain exceptions in which Medicare wouldn’t cover ambulance rides, including “transports in which some other means of transportation could be used without endangering the beneficiary’s health, regardless of whether the other means of transportation is actually available.”
Medicare may also not cover ambulance rides if “transports to a more distant hospital solely to avail the beneficiary of the services of a specific physician or physician specialist. Medicare will pay the base rate and mileage for a medically necessary ambulance transport to the nearest appropriate facility. If the transport is to a facility that is not the nearest appropriate facility, the beneficiary is only responsible for additional mileage to his or her preferred facility.”
In the meantime, Cole will wait, hoping her granddaughter’s appeal provides some relief.
