Residents wary about proposed ambulance fee

Some say insurance premiums could rise

But residents were skeptical, believing insurance premiums would eventually increase.

‘‘Nothing comes free,” said Rockville resident Harriet Altschuler during a June 26 meeting at the Margaret Schweinhaut Senior Center in Silver Spring. ‘‘Just because it’s paid by insurance and you’re not going to get a bill, your rates are still going to get spiked just like when you have a car accident.”

Some volunteer fire and rescue workers say residents may be reluctant to use their services if a fee is attached.

‘‘We think people will be afraid to call 911, and you should never be afraid to call 911,” said Darian Unger, a volunteer with Silver Spring Fire and Rescue.

Under the proposed plan, residents would ‘‘never see a bill” for ambulance transport regardless of their health insurance coverage, said John Best, who serves as a liaison to the Senior Citizen Fire Safety Task Force created by Leggett (D). The county would bill insurance companies, and people without insurance would not be charged, Best said.

The fees, which would go into effect Jan. 1, are expected to generate $14 million the first year to go toward increased staffing, new equipment, four new fire stations and other improvements.

Insurers would be charged between $300 and $800, depending on the type of service, plus $7.50 per mile for emergency transports. The county estimates that the average emergency transport trip is five miles.

Best said the county would accept any limited payment or payment refusal from private insurance companies as a payment in full.

In 2003, former County Executive Douglas M. Duncan (D) proposed an ambulance fee, but the County Council rejected the plan.

Best said Montgomery County is among the few jurisdictions in the region that does not charge ambulance fees and that health insurance companies already account for ambulance rides in their premiums.

‘‘It’s just money that’s there that the county is not collecting,” said Best, who called the fees ‘‘found money.”

The ambulance fees are not expected to have an impact on insurance premiums because the amounts are insignificant compared to hospital bills and other medical costs, Best said.

Ben Steffen, director of analysis and information services at the Maryland Health Care Commission, agreed the impact of the fees would likely be minor, but said any impact on the costs of a service can limit use of that service.

‘‘We know that’s true in health care that as patients pay more, use of a service tends to decline,” Steffen said.

Ambulance fees went into effect Tuesday in Prince George’s County. Fairfax and Frederick counties, as well as the District of Columbia and Baltimore City, also charge fees.

Michael Sullivan, a spokesman for CareFirst BlueCross Blue Shield, said in an e-mail that its customers would not be charged any additional fee as long as the ambulance service provider agrees ‘‘to accept payment under the terms of [CareFirst’s] fee schedule.” CareFirst BlueCross Blue Shield has more than 3.2 million clients in the Washington, D.C., region.

While Best said at the Schweinhaut meeting that the money from the fees would be allocated to fire and rescue services, some volunteers fear the revenue would negatively affect their operations, which are donation-based.

‘‘People will feel, ‘If I have to pay for the ambulance, why should I donate money to support this service that has been provided for over 50 years?’” said Tom Brown, president of the Wheaton Volunteer Rescue Squad.

If the fees are approved, Silver Spring resident Gaston Leon wondered what would keep the county from charging residents for other emergency services, such as responding to a house fire or a car accident. ‘‘This is just the beginning,” he said.

The County Council will hold a public hearing on the proposal 7:30 p.m. Tuesday.