Ambulance is not always free: Who pays for ambulance services?

Who pays for the ambulance? Is ambulance free?

Ambulance services are usually paid for by insurance policies and covered bygovernment aid such as medicare and medisave. The caller or next-of-kin will have to make the ambulance payment if insurance or government aid does not cover the cost. This is called out of pocket expenses.

Otherwise, ambulance fees can be paid first and claimed subsequently (pay-and-claim) from the insurance or public aid schemes. At the end of the day, ambulance services are not free. The insurance, government, caller or family member will have to foot the ambulance bill.

Treatment bills can be costly (Pictured: patient with spinal injury with oxygen support)

Details: When can I pay for my ambulance bill? Payment modes.

In an emergency, payment is collected by the ambulance staff after service is rendered (upon arrival at the hospital). You can pay the ambulance after the patient is received by hospital staff.

Most ambulance service providers accept cashless options such as QR code, bank transfer and credit/debit card. Cheques are typically not accepted as cheques can be cancelled by the issuer anytime afterwards. A dishonored cheque may cause finance and reconcillation issues thereafter.

The documentation or payment invoice serves as a record where the patient or relative will be able to pursue claims from their insurance partner as the ambulance attendants do not process such claims related to insurance on-site.

More FAQ answers on calling an ambulance here.

More FAQ answers on calling an ambulance for others here.

Can I include the ambulance bill into the hospital bill?

Unfortunately, it is becoming increasingly uncommon for ambulance bills to be included in the final hospital bill.

Hospital bills vary greatly based on the procedures and treatment required for the patient (this can happen very suddenly) and the distinction between various entities. Therefore the hospital bill can increase which may lead to an incorrect final amount.

Using this wrong amount and submitting it to an insurance company or a government-funded / linked healthcare plan can lead to fraud.

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Fees: How much is it to call an ambulance?

Medical services in a moving vehicle do not come cheap. To call an ambulance, be prepared to pay at least $150 (USD) regardless of country you are in.

Primarily, the ambulance will take the vital sign measurements such as heart rate, blood pressure and oxygen levels upon arrival at scene. This is one of the most basic steps needed to assess the patient.

This does not include medical procedures and further treatments which are done on the spot to help improve the patient’s condition.

A broken ankle: X-Rays, bandaging and leg-casts are not standard treatments.

Why are additional medical procedures required in an ambulance?

Additional procedures such as doing an ECG to assess the heart functions and see the heart rhythm are vital in thoroughly assessing the patient. This can reveal underlying heart issues.

Example: Patient having ECG taken. You can see the 4 wires (red, yellow, green and black) connected. She had a fall. Blood pressure (Blue band on the arm) & oxygen levels (probe on the finger) are also recorded.

Another commonly practiced procedure is the IV therapy (Intra Venous). This is used to gain access to the vein and blood stream. The medic will be able to draw blood to measure the level of sugar in the blood.

IV injection on the artery (vein is located near the ankle)

Also, IV is used to deliver medication through the vein and this is known to be more effective than administering the same medicine by mouth or lotion on the skin surface. The medicine will reach all parts of the body quicker via the blood-stream.

On-site assessment: results of an abnormal ECG reading

Without doing such medical procedures and getting the appropriate consent for these treatments, there can be a risk to the patient’s life and well-being.

Medics will offer these to you (or next-of-kin / family) as treatment options. Most people willingly take up the treatment if they can be performed on-site, instead of waiting to get it done way later when the patient reaches the hospital emergency room.

Why is calling an ambulance expensive?

Ambulance services are more expensive than hospital treatment.

In a moving vehicle, there is a need to bring all necessary medical equipment along in a compact size. Further, to have onboard trained and experienced personnel who can use those equipments to save lives is necessary. You will have to factor these as consideration points to calculate your bill.

Related info you will find useful:

Someone or somebody has to pay for the ambulance bill at the end of the day!

Additional Costs due to COVID-19

For some countries, if the ambulance crew has to be served with stay home notice or notice of quarantine, charges may be incurred.

Medical crew showing his “stay home notice” form

For the ambulance team to be mandated to stop work for 14 days, there will be a great financial loss involved. Capacity to provide medical services to the public will be diminished.

Equipment cost

Portable equipment are generally more costly as they are manufactured and programmed to operate wirelessly and on batteries. These equipment have vital life-saving functions which have to last for hours.

The ambulance does not have the opportunity to be continuously plugged in into a wall outlet to get an unlimited supply of electricity.

This contributes to the total cost of ambulance bill.

Replaceable battery (right) of the defibrillator (left)

Employee cost

In the current day and age, employees are increasingly unwilling to work in physical environments. People prefer to work in desk jobs or air conditioned environments. 

However, an ambulance does not provide such a cosy environment and are associated with sweat and manual labour.

Handling a critical care patient: Cosy workplace in a hospital versus the rush in an ambulance

Paramedics who work in the ambulance line are known for their strong passion and conviction to save lives and they enjoy the rush of rescue work. Adrenaline will spike. They continue a career in the ambulance service and many love to be the first responder who helps the patient on-site.


Ambulance service is a core component to the healthcare system worldwide. Even though calling an ambulance can be expensive, the cost is usually covered by insurance, government aid or other pay-and-claim options.

The bill can increase if the patient requires further medical procedures but if these procedures are needed, then the family has to be prepared for a larger bill.

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This post was last modified on March 17, 2021 5:49 pm