Ohio toddler's 40-minute ambulance journey results in a $9,000 bill: How a loophole in surprise billing regulations is harming Americans

As medical costs climb nationwide, families are increasingly facing staggering bills that they cannot cover. One recent example comes from Mechanicsburg, Ohio, where Elisabeth Yoder revealed that her 15-month-old son, Darragh, received an unexpected ambulance bill totaling $9,250.

In August, Darragh initially showed signs of a routine viral infection, but his condition deteriorated, causing blisters and peeling skin on his face. Yoder took him to Mercy Health Hospital in Urbana, where doctors recommended a transfer to a nearby childrens hospital via a private ambulance service.

Although the 40-minute trip seemed uncomplicated, the ambulance bill included a $6,600 base fee, $2,340 for mileage, $250 for an IV pump, and $60 for blood oxygen monitoring. By comparison, the toddlers three-day stay at the childrens hospital cost only about $3,000 more.

The family does not have traditional insurance and relies on a Christian health care sharing ministry. Their income is slightly above the Medicaid threshold, leaving them with few options to handle the exorbitant ambulance charges.

Legal Gaps for Ground Ambulances

Health care sharing ministries do not negotiate rates with ambulance companies or medical providers. In Ohio, there are no protections for uninsured patients against high ground ambulance bills. The federal No Surprises Act, which shields insured patients from large out-of-network air ambulance bills, does not cover ground ambulance services.

Patricia Kelmar, senior director of health care campaigns at PIRG, explained that patients are rarely informed about ambulance costs beforehand. She noted wide variability in per-mile charges, from under $30 to over $80, and significant differences in base fees. According to a 2022 PIRG report, about half of insured emergency ambulance patients risk receiving surprise bills, with median out-of-pocket costs of $450 and averages exceeding $1,000 in some states.

Yoder negotiated with the ambulance company, which offered to reduce the bill to $5,600 if paid in full upfront. She used a credit card with a 17-month no-interest period to cover the cost. After charity discounts, hospital bills were reduced to $6,800. The family expects their sharing ministry to reimburse roughly 75% of the total expenses.

Planning for Medical Costs

This situation emphasizes the importance of proper health insurance and self-advocacy for medical expenses. The No Surprises Act protects insured patients from unexpected out-of-network charges but does not cover uninsured families.

Patients should request a good faith estimate for scheduled care, review itemized bills, and dispute any questionable charges. Assistance from patient advocates or financial aid programs can also help reduce medical debt.

Managing Medical Debt

According to KFF data, around 14 million Americans owe over $1,000 in medical debt, and 3 million owe more than $10,000. Options for reducing medical debt include charity care, Medicare Savings Programs, credit counseling, and state-based social services. Setting aside a portion of monthly income or maintaining a Health Savings Account (HSA) can help families prepare for unexpected health expenses.

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• Ohio toddler’s 40-minute ambulance ride came with a $9K bill. How an exception to surprise billing rules hurts Americans