Frequently Asked Questions
What is the Emergency Medical Services (EMS) Transport Insurance Reimbursement Program?
The EMS Program will allow Montgomery County to be reimbursed for emergency medical services from private health insurance companies, Medicare or Medicaid for transports by the Montgomery County Fire & Rescue Service. County residents will not pay any out-of-pocket expenses for co-pays, deductibles, or any other uninsured EMS cost.
Is the EMS Program the only County program that seeks insurance reimbursement?
No. The County currently seeks reimbursement from commercial insurers, Medicare and Medicaid for other health care services provided by the County, including services relating to adult and child behavioral health, outpatient addiction services, obstetrics, school health, and infants and toddlers early intervention. This fiscal year, about $4 million in costs will be recovered.
How much money would the County receive through the EMS reimbursements?
The EMS Program will generate an estimated $18 million a year -- or $180 million over 10 years – without raising taxes, without raising fees, and without costing residents anything.
Why do we need the Emergency Medical Services (EMS) Transport Insurance Reimbursement Program?
Montgomery County is about to be hit by a “tidal wave” from Annapolis. The State of Maryland has recently decided to shift over $400 million over 10 years in state teacher pension costs to Montgomery County. The State has also approved an inflexible “Maintenance of Effort” law on school funding that could force us to add at least $25 million to our reserves each year above and beyond what we already do.
How will the money raised by the EMS Program be used?
One-hundred percent of the net proceeds of the EMS Program will go towards Montgomery County Fire & Rescue Service to improve and expand critically needed services and save County lives and property. By law, the money recovered from insurers will be dedicated to that purpose and cannot be used for anything else. Spending less taxpayer dollars to enhance essential Fire & Rescue services frees up money that can be spent on other core needs, such as education; other public safety services; the safety net for seniors and the most vulnerable; libraries; recreation centers; and road maintenance.
Will I see any difference in Montgomery County EMS service?
No. There is no evidence that similar EMS laws in other jurisdictions have resulted in any reluctance on the part of residents to call for emergency services. Montgomery County’s Fire & Rescue Service will continue to provide the very best service to any individual in need – regardless of ability to pay – just the way it’s always worked.
Will I receive a bill for EMS transport?
No. County residents will never receive a bill. Instead, the County will bill private insurers, Medicare or Medicaid for emergency services. County residents will not be responsible for any co-pays, deductibles, or other out-of-pocket expenses. For those without health insurance, reimbursement will be waived.
How can I be sure that my ability to pay won’t affect my service?
The EMS Program law specifically states, “The Fire & Rescue Service must provide emergency medical services transport under applicable medical protocols to each individual without regard to the individual’s ability to pay. Personnel of the Fire & Rescue Service who respond to a request for an emergency medical services transport must not ask any information relating to the individual’s insurance coverage.”
If private insurers are billed, will this raise my insurance premium?
No. The costs of emergency services are already included in the premiums charged by insurers. Rates are set regionally and nearly all of our surrounding jurisdictions already have EMS reimbursement programs. Instead of collecting reimbursements for emergency services, County taxpayers are footing the bill, boosting profits for insurers.
Will there be co-pays and deductibles?
County residents will not be billed for any out-of-pocket expenses. Non-County residents may be responsible for co-pays and deductibles, depending on their policies. However, they will also be eligible for a waiver of those costs if they meet financial hardship criteria.
Do other jurisdictions get EMS reimbursement?
The EMS Program would allow Montgomery County to join nearly all of Maryland, the District of Columbia and most jurisdictions in Virginia in recovering millions of dollars in costs from insurers. In fact, the majority of communities in the United States recover EMS costs through reimbursement.
What if my health insurer only pays a portion of the emergency medical services or refuses to pay?
Under the EMS Program, the County will accept whatever payment an insurer makes on behalf of a resident as “payment in full.” Residents will not have to deal with any questions or disputes about payment. Issues that arise will be resolved by a company hired by the County to handle the reimbursements.
What if I still have a problem related to the services I received that are covered by the EMS Program?
Under the EMS Program law, a County Patient Advocate will address any questions and concerns and ensure that the company hired to handle the reimbursements provides the highest quality customer service.
How will people learn about the EMS Program?
The law requires development of a public education campaign to ensure that residents and employees in the County understand the new program and how it works..