How much an ambulance ride costs when you have no insurance

Call 911 first and worry about the bill later

If someone has chest pain, trouble breathing, signs of a stroke, heavy bleeding or a serious injury, call 911. You should not wait to find out the price. Bills can be handled afterward, and there are real ways to lower them.

A federal law called EMTALA says an emergency room must examine you and treat an emergency whether or not you have insurance. This page is general information and not medical advice, and it will help you understand the bill after the fact.

What an ambulance ride costs without insurance

We cannot give you one price because none exists, since each ambulance service sets its own charges. Some are run by a city or county, some by a fire department, some by a hospital and some by a private company. The bill depends on who sent the ambulance and how far you went.

One useful number comes from the Health Care Cost Institute, a nonprofit research group. Its 2022 analysis found that employer insurance plans paid a median base rate of $718 per one-way ground trip. The plans also paid a median of $17 for each mile. A median is the middle number when you line up all the prices from lowest to highest. That figure shows what insurers paid, and it is not a price list for people without insurance. Charges to uninsured patients can be higher or lower.

A few things can raise the bill, and these are the most common ones.

• Distance matters, since most services charge by the mile from where you were picked up to the hospital.
• The level of care on board matters too, because a crew with advanced training usually has a higher rate than a basic crew.
• Medicines, oxygen or other supplies used during the ride can add charges.
• The time of day or the place can change the rate, because rates differ by service and by area.

Ground ambulance bills are often a surprise

In 2022, a federal law called the No Surprises Act began to protect many people from some surprise bills. CMS, the federal agency that runs Medicare and Medicaid, says that air ambulances are usually covered by those protections. It also says that ground ambulances generally are not covered, unless a state law says otherwise. That means a ground ambulance service can still send a large bill.

Those protections mostly help people who have private insurance. These federal protections do not limit the ambulance bill when you have no insurance, but you still have options. Some states have their own laws about ambulance bills, and the rules differ by state. You can ask your state insurance department or consumer office what applies where you live.

You also probably did not get a price in advance. Federal rules give uninsured people a written estimate for care they schedule ahead of time. Those rules do not apply to a 911 call. The federal medical bill rights pages explain when you get one.

What to do when the ambulance bill arrives

Please do not ignore the bill, and take these steps in order.

1. Open it right away, and write down the due date and the phone number.
2. Ask for an itemized bill, which is a list of every charge, including the base fee and the mileage.
3. Check the list for mistakes, such as a wrong date, a wrong distance or a repeated charge.
4. Call the billing office and explain that you have no insurance, then ask what discounts or hardship plans exist.
5. Ask for a lower self-pay price, and ask whether you can pay over time with no interest.
6. Write down the date, the name of the person and what they agreed to, and ask for any deal in writing.

A call script you can use is in our guide on how to negotiate medical bills.

Call before the due date and say so if you cannot pay right now. A service is often more willing to set up a small monthly plan when you reach out early. If a bill has already gone to a collector, our guide on medical bills in collections explains your rights.

Financial help with an ambulance bill

Ambulance services run by a city, county or fire department may have a hardship process, since they answer to local officials. Ask the billing office what forms exist and what proof of income it needs.

At the same visit, ask the hospital about its financial assistance policy if the ambulance took you there. Nonprofit hospitals must have such a policy, under IRS rules. That policy may not cover a separate ambulance company, but it can help with the hospital bill, so ask both places. The hospital financial assistance guide explains how to apply.

You can also call 211 to ask about local programs, and you can check whether you now qualify for Medicaid. Our guide on getting health insurance without a job covers how to apply, and you can apply for Medicaid at any time of year.

Other ways to get to the hospital or to care

In a true emergency, an ambulance is often the best way to get care. The crew can start treatment on the way, and they can pick the right hospital. Call 911 if you think a person's life is in danger. Never try to drive someone who cannot be moved safely.

For problems that are not emergencies, there are lower-cost options that do not involve a 911 call. A regular doctor, a community health center or a cash-pay doctor may be able to see you the same day. To see who is close, search for a cash-pay doctor near you. The guide on the ER with no insurance explains what happens after you arrive.