In Focus Alert: Extreme Weather

UNITED STATES OF AMERICA / GULF COAST

FPI sources are reporting that two tropical depression systems developing in the Atlantic are scheduled to make landfall at hurricane strength on the southern Florida Peninsula and the Gulf Coast as early as Monday, 24 August 2020. The pair of tropical systems are both on a path that would take them into the Gulf Coast at the same time over the weekend. Tropical Storm Laura and Tropical Storm Marco have nearly the entire Gulf Coast on alert for potential impacts, and they could become the first pair of systems to be in this part of the Atlantic Basin at the same time in decades.

Tropical Storm Laura developed in the Atlantic just a couple of hundred miles east-southeast of the northern Leeward Islands on Friday morning with maximum sustained speeds of 45 mph. Laura is projected to bring tropical storm conditions as it moves along with the potential for more significant conditions, depending on the exact track and strength of the feature itself. The storm is forecasted to affect people across the northern islands of the Caribbean, as well as the Turks and Caicos, southern Bahamas, the Florida Keys and the southern part of the Florida Peninsula.

Tropical Storm Marco formed about 180 miles southeast of Cozumel, Mexico, and had maximum sustained winds of 40 mph with a north-northwest movement at 13 mph. Heavy rain and gusty winds will continue to spread into the northeastern Yucatan Peninsula as the storm heads northwest this weekend into the Gulf of Mexico. Damaging winds are also expected, especially in exposed windward locations like coastal areas around and north of the center of the storm. These areas are most likely to be impacted by destructive onshore winds. Should the storm remain stronger, these areas could also experience coastal flooding.

Travelers and residents along the western Gulf Coast of the U.S. should keep a close eye on the system’s strength and forecast track and make storm preparations now before landfall. Residents and travelers in possible affected areas are advised to continue practicing social distancing and safe hygiene measures as well as to stay away from the beach, water bodies, move to higher ground, follow local media sources for updates, and monitor the status of flights.

In the event of a hurricane, please take the following precautions.

BEFORE A HURRICANE:

  • Have a disaster plan.
  • Board up windows.
  • Bring in outdoor objects that could blow away.
  • Know where all the evacuation routes are.
  • Prepare a disaster supplies kit for your home and car. Have enough food and water for at least 3 days. Include a first aid kit, canned food and a can opener, bottled water, battery-operated radio, flashlight, protective clothing and written instructions on how to turn off electricity, gas, and water.
  • Have some cash handy. Following a hurricane, banks and ATMs may be temporarily closed.
  • Make sure your car is filled with gasoline.
  • Keep important documents in a waterproof container. Create password-protected digital copies.

DURING A HURRICANE:

  • Stay away from low-lying and flood prone areas.
  • Always stay indoors during a hurricane as strong winds will blow things around.
  • Leave mobile homes and to go to a shelter.
  • If your home isn’t on higher ground, go to a shelter.
  • If emergency managers say to evacuate, then do so immediately.

AFTER A HURRICANE:

  • Stay indoors until it is safe to come out.
  • Check for injured or trapped people, without putting yourself in danger.
  • Watch out for flooding which can happen after a hurricane.
  • Do not attempt to drive in flooding water.
  • Stay away from standing water. It may be electrically charged from underground or downed power lines.
  • Don’t drink tap water until officials say it’s safe to do so.

FocusPoint International is monitoring this developing situation. FocusPoint’s Crisis Response Center is prepared to provide assistance 24/7. Please do not hesitate to contact us at any time, day or night.

CRC / BAG / BJN / ONO 

22 August 18:32 (UTC)

Sexual Orientation Laws Across the Globe

Check out CAP’s travel medical and security assistance plans that include benefits that can enhance your LGBTQ travel experience here.

5 Tips for Managing a Remote Workforce

  1. Create and Manage Expectations
    Draft realistic expectations and help your team understand what their tasks are, how to prioritize, and action them for everyone’s success
  2. Utilize Technology
    Keep your team connected with tools that enhance communication and are best suited for collaboration
  3. Ensure Daily Check-ins
    Utilize an app that has a remote check-in, like CAP™ Advantage’s one-touch check-in feature, so all remote staff can be accounted for when a face-to-face video call is not always feasible
  4. Provide Adequate Resources
    Make sure that all staff have high-speed internet connections, mobile devices, software, laptops, and any other tools required to perform their tasks
  5. Communicate, Communicate, Communicate
    One of the challenges that come with working remotely from home, given that most staff are used to being in an office with other employees, is a sense of loneliness that can set in, so be sure to communicate regularly

 

If you’d like to learn more about deploying the CAP™ Advantage Mobile App to support the management of a remote workforce, please contact us at [email protected]. You can also visit us online for more information via www.captravelassistance.com.

7 Ways You Can Protect Yourself & Others From COVID-19

Find a travel assistance plan with emergency response and assistance benefits for viral outbreaks like COVID-19.  Learn more about what the CAP plan includes.

Novel Coronavirus (COVID-19) Update

LATEST UPDATES FOR THE WEEK OF 21-28 FEBRUARY

The outbreak of COVID-19 has now reached a global dimension as it has seen a significant increase in cases outside of China over the last week, with significant local outbreaks reported in South Korea, Japan, Iran and Italy.

Defer non-essential travel to China and Iran until further notice.

Travellers to South Korea should reconsider their need to travel due to widespread community transmission.

Travellers to Japan or Italy should exercise caution if travelling to affected areas of the country.

Travellers should note that older adults or travellers with chronic medical conditions are more vulnerable to the virus and should be postponing nonessential travel to any of the destinations above. Before travelling to an affected area, travellers should monitor the latest directives from international health authorities and verify their insurance coverage carefully. Travellers on an essential visit should liaise with their consular authorities, reduce the length to their stay to a minimum, and make contingency plans for evacuation. Travellers should note that lockdown measures could be introduced at a very short notice in areas with sustained number of infections, and if there are any indications that such measures could be introduced, they should leave the location while they still can. All travellers should exercise adequate health measures, including maintaining social distancing, washing hands frequently, avoiding, touching eyes, nose and mouth, and practicing respiratory hygiene; travellers should monitor any flu-like symptoms that could appear up to 14 days after infection.

Significant uptick in confirmed cases and fatalities in Italy

Authorities confirmed new cases of the novel coronavirus (COVID-19) in several regions, bringing the death toll to at least 29, as the number of confirmed infections rose to at least 1,128 across 13 regions, with Lombardy, Veneto and Emilia-Romagna the worst-affected. 11 towns in Lombardy and Veneto regions have been in lockdown since 23 February in order to contain any further spread of the virus.

Iranian officials attempt to limit the outbreak’s spread

Public health officials in Iran cancelled classes at schools and universities as well as suspended Friday prayers in Tehran and 22 other cities to try to limit the spread of the outbreak; at least 593 cases of COVID-19 and 43 associated fatalities were recorded nationwide as of 29 February. Restrictions on public gatherings and travel are in place in Qom province, the epicentre of the outbreak, while individuals with suspected and confirmed cases of COVID-19 are subject to domestic travel restrictions and 14-day quarantine procedures nationwide.

Regional impact of Italy’s and Iran’s cases: according to the World Health Organisation (WHO) at least 14 countries reported cases exported from Italy, while another 11 countries reported cases exported from Iran during the week, triggering travel restrictions for travellers from both countries, by both land and air.

South Korea reports more daily cases than mainland China

Authorities confirmed 571 new COVID-19 cases on 28 February, bringing the total number of infections to 2,337, which included 16 deaths. The worst-affected areas are Daegu and North Gyeongsang province, where “special care zones” were declared in Daegu and Cheongdo, with residents advised to remain indoors to limit the spread of the disease.

First cases confirmed in Latin America

Public health officials in Brazil announced the first case of the COVID-19 in a 61-year-old man in São Paulo on 26 February, Mexican health officials confirmed that a 35-year-old man tested positive for the COVID-19 infection in Mexico City on 28 February and Ecuadorian doctors confirmed the country’s first case on 29 February in a 70-year-old resident who recently returned from Spain.

Coronavirus continues to spread within the United States

Centers for Disease Control (CDC) officials in the US announced that public health authorities expect that the outbreak, which has largely been contained among returning travellers and members of their immediate families, will spread. Cases of community spread, unconnected to foreign travel, were reported in California, Oregon and Washington states as of 29 February; travel bans are in place for China and Iran.

 

Cumulative Confirmed Cases

Covid-19 Cases Map Graphic

90,309 Total Confirmed Cases

by Country/Region

  • 80,026 Mainland China
  • 4,335 South Korea
  • 2,036 Italy
  • 1,501 Iran
  • 705 Others
  • 274 Japan
  • 191 France
  • 159 Germany
  • 120 Spain
  • 108 Singapore
  • 101 US
  • 98 Hong Kong
  • 56 Kuwait
  • 49 Bahrain
  • 43 Thailand
  • 42 Switzerland
  • 41 Taiwan
  • 40 UK
  • 30 Australia
  • 29 Malaysia
  • 27 Canada
  • 26 Iraq
  • 25 Norway
  • 21 United Arab Emirates
  • 18 Netherlands
  • 18 Austria
  • 16 Vietnam
  • 15 Sweden
  • 13 Lebanon
  • 10 Israel
  • 10 Macau
  • 8 Belgium
  • 8 San Marino
  • 7 Croatia
  • 7 Greece
  • 6 Ecuador
  • 6 Iceland
  • 6 Oman
  • 6 Finland
  • 5 Mexico
  • 5 India
  • 4 Denmark
  • 4 Pakistan
  • 3 Qatar
  • 3 Czech Republic
  • 3 Georgia
  • 3 Algeria
  • 3 Philippines
  • 3 Russia
  • 3 Romania
  • 3 Azerbaijan
  • 2 Indonesia
  • 2 Brazil
  • 2 Portugal
  • 2 Egypt
  • 1 Afghanistan
  • 1 Nepal
  • 1 Lithuania
  • 1 Cambodia
  • 1 Andorra
  • 1 Ireland
  • 1 Nigeria
  • 1 Senegal
  • 1 Armenia
  • 1 Dominican Republic
  • 1 Estonia
  • 1 North Macedonia
  • 1 Morocco
  • 1 Luxembourg
  • 1 Monaco
  • 1 Belarus
  • 1 New Zealand
  • 1 Latvia
  • 1 Sri Lanka

3,085 Total Deaths

by Country/Region

  • 2,803 Hubei Mainland China
  • 66 Iran
  • 52 Italy
  • 28 South Korea
  • 22 Henan Mainland China
  • 13 Heilongjiang Mainland China
  • 8 Beijing Mainland China
  • 7 Guangdong Mainland China
  • 6 Japan
  • 6 Anhui Mainland China
  • 6 Chongqing Mainland China
  • 6 Hebei Mainland China
  • 6 Shandong Mainland China
  • 6 “Diamond Princess” cruise ship Others
  • 5 Hainan Mainland China
  • 5 King County, WA US
  • 4 Hunan Mainland China
  • 3 France
  • 3 Shanghai Mainland China
  • 3 Sichuan Mainland China
  • 3 Tianjin Mainland China
  • 3 Xinjiang Mainland China
  • 2 Hong Kong Hong Kong
  • 2 Gansu Mainland China
  • 2 Guangxi Mainland China
  • 2 Guizhou Mainland China
  • 2 Yunnan Mainland China
  • 1 Western Australia Australia
  • 1 Fujian Mainland China
  • 1 Jiangxi Mainland China
  • 1 Jilin Mainland China
  • 1 Liaoning Mainland China
  • 1 Shaanxi Mainland China
  • 1 Zhejiang Mainland China
  • 1 Philippines
  • 1 Taiwan Taiwan
  • 1 Thailand
  • 1 Snohomish County, WA US

45,602 Total Recovered

by Country/Region

  • 33,934 Hubei Mainland China
  • 1,205 Henan Mainland China
  • 1,069 Zhejiang Mainland China
  • 1,059 Guangdong Mainland China
  • 917 Anhui Mainland China
  • 887 Hunan Mainland China
  • 850 Jiangxi Mainland China
  • 543 Jiangsu Mainland China
  • 469 Chongqing Mainland China
  • 460 Shandong Mainland China
  • 386 Sichuan Mainland China
  • 356 Heilongjiang Mainland China
  • 296 Hebei Mainland China
  • 292 Shanghai Mainland China
  • 291 Iran
  • 282 Beijing Mainland China
  • 255 Fujian Mainland China
  • 216 Shaanxi Mainland China
  • 192 Guangxi Mainland China
  • 168 Yunnan Mainland China
  • 151 Hainan Mainland China
  • 149 Italy
  • 119 Shanxi Mainland China
  • 114 Guizhou Mainland China
  • 111 Tianjin Mainland China
  • 103 Liaoning Mainland China
  • 85 Gansu Mainland China
  • 83 Jilin Mainland China
  • 78 Singapore
  • 69 Ningxia Mainland China
  • 66 Xinjiang Mainland China
  • 54 Inner Mongolia Mainland China
  • 36 Hong Kong Hong Kong
  • 32 Japan
  • 31 Thailand
  • 30 South Korea
  • 18 Qinghai Mainland China
  • 18 Malaysia
  • 16 Germany
  • 16 Vietnam
  • 12 France
  • 12 Taiwan Taiwan
  • 10 “Diamond Princess” cruise ship Others
  • 8 Macau Macau
  • 8 UK
  • 5 United Arab Emirates
  • 4 New South Wales Australia
  • 4 Victoria Australia
  • 3 British Columbia Canada
  • 3 India
  • 2 South Australia Australia
  • 2 Toronto, ON Canada
  • 2 Russia
  • 2 Spain
  • 2 Cook County, IL US
  • 1 Queensland Australia
  • 1 Belgium
  • 1 Cambodia
  • 1 London, ON Canada
  • 1 Egypt
  • 1 Finland
  • 1 Israel
  • 1 Tibet Mainland China
  • 1 Nepal
  • 1 Oman
  • 1 Philippines
  • 1 Sri Lanka
  • 1 Boston, MA US
  • 1 King County, WA US
  • 1 San Diego County, CA US
  • 1 Santa Clara, CA US
  • 1 Tempe, AZ US

 

As of 3/2/2020, 4:13:08 PM

Source : Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE

Travel Insurance Benefits May Not Be Enough During The Coronavirus Outbreak

8 Travel Assistance Benefits You Can Access During The Coronavirus Outbreak

CAP™ benefits associated with responding to and supporting customers impacted by the Coronavirus include:

  1. Destination-based travel risk intelligence is provided to travelers via web, SMS, email and in-app alerts throughout their journey.
  2. 24/7 on-demand advice on how to minimize and mitigate exposure when traveling within an impacted area.
  3. Advice on how to control movement, shelter in place and evacuate the affected area if possible.
  4. Access to interpreters to facilitate communications between customers and local personnel.
  5. Emergency message transmission to employers and loved ones regarding the status of customers directly impacted by the virus during travel.
  6. Coordination and liaison with host and home government entities to assist in facilitating the safe movement of customers in affected zones.
  7. In-direct medical assessments with local medical personnel that interact with customers directly impacted by the virus.
  8. Evacuate customers in impacted areas that are not under quarantine and/or symptomatic.

Customers traveling in areas directly impacted by the Coronavirus that purchased CAP™ prior to the WHO declaring a global health emergency, would be eligible for assistance, up to and including evacuation for no additional costs.

Customers that purchased CAP™ for travel destinations not previously impacted by the Coronavirus, but became impacted during a qualifying period of travel (i.e., vacationing on a cruise ship that has no confirmed cases of Coronavirus, but suddenly undergoes a quarantined status, due to a person becoming symptomatic during the course of the cruise), would also be eligible for assistance, up to and including evacuation for no additional costs, once the customer(s) was cleared from quarantined status.

CAP™ customers who willingly travel to a destination directly impacted by the Coronavirus, after the WHO has declared a global health emergency and the host and/or home government has warned against ALL travel to the impacted area(s) would not be eligible for fully funded assistance.

Learn more about CAP.

Travel Advisory China: Coronavirus

ASIA / CHINA / WUHAN

FPI sources are reporting that on January 23 the Chinese authorities have put a lockdown on the city of Wuhan and other urban areas of Hubei province – including Huanggang and Ezhou following the outbreak of the coronavirus that has left over 571 people infected with 17 fatalities.  All outbound passenger travel, including air, rail, and long-distance bus transport, has been suspended. In light of this, FocusPoint International is advising against all further, non-essential travel to the Hubei province in China.

The Wuhan coronavirus is currently thought to be a more mild form of the SARS and MERS viruses that takes longer to develop symptoms. The virus infects the lungs, and symptoms start with a fever and cough. It can progress to shortness of breath and breathing difficulties. All the fatalities so far have been in Hubei, the province around Wuhan.

The World Health Organization (WHO) is yet to declare a global emergency over the new virus. Chinese authorities have suspended all flights and passenger train services out of Wuhan. Bus, subway, and ferry services have also been shut down. A specialized command center has been set up in Wuhan to contain the virus.

FPI advises travelers in the region to reduce the risk of infection by avoiding people who are sick. Try to avoid touching your eyes, nose, and mouth. Wash your hands often with soap and water for at least 20 seconds. If you are sick and have reason to believe it may be the Wuhan coronavirus, due to travel to the region or coming into contact with someone who has been there, you should let a health care provider know and seek treatment early. Cover your mouth and nose when you cough or sneeze and disinfect the objects and surfaces you touch. If traveling to China, be aware of symptoms and avoid live animal markets, which is where the latest outbreak began in Wuhan.

Travelers in the region are advised to partake in local precautionary measures, such as temperature screenings and necessary vaccinations.

FocusPoint International is monitoring this developing situation. FocusPoint’s Crisis Response Center is prepared to provide member assistance 24/7. Please do not hesitate to contact us at any time, day or night.

CRC / JLL / KRD / BAG

Planning Travel to Areas That Have a Nexus With Potential Exposure?

CAP™ Travel Assistance Plans include 24/7, unlimited advice and coordinated, in-country crisis assistance up to and including evacuation for Pandemic Outbreaks.  Engaging CAP™ requires no additional fees, claims forms, deductibles, reimbursements or subrogation to other insurance programs.  CAP™ Travel Assistance is not insurance.  CAP™ Travel Assistance Plans will not indemnify or reimburse customers for expenses incurred directly by the CAP™ customers.

Get a free quote!

Travelers who have already purchased a CAP™ Plan: For immediate emergency assistance please call +1.619.717.8549

What Some Travel Insurance Policies Do Not Cover

Exclusions and Conditions Could Result in Travel Insurance Benefits Not Being Paid Out

Travel insurance is a must for any vacation or business traveler. However, many consumers don’t realize their coverage can sometimes come with a long list of exceptions and details that could result in their benefits not being paid in the event of an injury, or worse, death. Much of these exceptions are overlooked, as consumers fail to read through all the fine print of their coverage or misunderstand what their coverage entails.

Many travel insurance plans offer thousands of dollars of coverage and have proven to be beneficial for many travelers. However, when a traveler learns that their emergency can’t be resolved with their insurance, their vacation and/or business trip could become a nightmare.

Consider Your Pre-Existing Health Conditions When Purchasing Travel Insurance

A traveler’s pre-existing health condition can exclude the payment of benefits in travel insurance plans. Those traveling with pre-existing heart conditions, lung or respiratory conditions,aneurysm, or cancer prior to their travel date might be surprised to learn that these conditions could void their coverage. Depending on the insurance plan, costs incurred due to these pre-existing conditions would not be covered.

Alcohol Use Can Complicate Travel Insurance

Some plans include fine print outlining that benefits are not payable for loss, injury or death if the traveler was under the influence of drugs or alcohol, or any other intoxicant, failed to comply with prescribed treatment or therapy or misused a medication.

Adventure travelers might also be surprised to learn that their benefits are not payable if the injury is a result of extreme sports, including motorized contests, high-risk activities, stunts, professional sports, mountain climbing, and in some instances, rock climbing.

Benefits could also not be payable when a traveler’s home country issues a travel warning to a specific country, and the injury or sickness is a result of the reasons outlined in the travel warning. This could cover a wide range of instances when travel insurance coverage is voided, including war, kidnapping, nuclear incidents, and acts of terrorism.

Find Resolutions to Your Travel Insurance Needs

The CAP Travel Assistance Plan (CAP™) powered by FocusPoint International is an affordable, elite travel assistance plan with a comprehensive benefit structure that includes a wide assortment of industry-leading emergency medical travel assistance benefits. We are proud to offer best-in-class crisis response, evacuation and travel security assistance service, all available for one inexpensive plan fee.

CAP™ is offered by some of the world’s leading airline operators and travel agencies and is now available to purchase online for individuals and families looking to fill the frequently overlooked gaps in their travel insurance policy. Travel mishaps like natural disasters, terrorism, and sometimes criminal violence are not covered by traditional travel insurance. Visit us online to get a complimentary quote and learn more about what CAP™ can do for you.

Taken For A Ride: M.D. Injured In ATV Crash Gets $56,603 Bill For Air Ambulance Trip

Credit:
www.npr.org All Things Considered
https://twitter.com/npratc

Source:
https://www.npr.org/sections/health-shots/2018/09/25/647531500/taken-for-a-ride-doctor-injured-in-atv-crash-gets-56-6 03-bill-for-air-ambulance

It was the first — and only — time Dr. Naveed Khan, a 35-year-old radiologist, ever rode in an all-terrain vehicle.

Khan took the wheel from his friend and drove circles in the sand, on a trail along the Red River in Texas.

“As soon as I turned to the side where my body weight was, this two-seater vehicle … just tilted toward the side and toppled,” Khan recalled. It landed on his left arm.

“I had about a 6-inch-wide exposed flesh gap that I could see below, on my forearm,” he said. “And I could see muscle. I could see the fat. I could see the skin. The blood was pooling around it.”

Khan, feeling lightheaded, tied his jacket around his arm like a tourniquet. He and his friend managed to right the ATV, drive back toward the street and call 911.

When an ambulance delivered him to the emergency room at United Regional Health Care System in Wichita Falls, Khan was surprised to hear a doctor murmur that it was the worst arm injury he’d ever seen.

Khan needed immediate helicopter transport to a trauma center for surgery in Fort Worth, if there was any hope of saving the arm.

Groggy from painkillers, Khan managed to ask the doctors how much the flight would cost and whether it would be covered by his insurer. “I think they told my friend, ‘He needs to stop asking questions. He needs to get on that helicopter. He doesn’t realize how serious this injury is,’ ” Khan recalled.

Flown 108 miles to John Peter Smith Hospital in Fort Worth, the closest Level I trauma center, Khan was whisked into surgery to clean out the wound, repair his shattered bones and get blood flowing to the tissue.

He had a total of eight operations to try to save his left forearm before he finally gave up. After weeks in the hospital, he asked the doctors to amputate, so he could get on with his life.

And then the bill came.

Patient: Naveed Khan, 35, a radiologist and married father of three young children in Southlake, Texas.

Total bill: $56,603 for an air ambulance flight. Blue Cross Blue Shield of Texas, Khan’s insurer, paid $11,972, after initially refusing altogether; the medevac company billed Khan for the remaining $44,631.

Service provider: Air Evac Lifeteam, an air ambulance company that operates 130 bases in 15 states. It’s owned by Air Medical Group Holdings, a holding company that owns four other air ambulance companies and one ground ambulance company. Air Medical, in turn, is owned by the giant private equity firm Kohlberg Kravis Roberts.

Medical service: Khan was flown from the United Regional Health Care System in Wichita Falls, Texas, to the John Peter Smith Hospital in Fort Worth.

What gives: Khan got his first call from Air Evac Lifeteam just three days after the accident, while he was still lying in the hospital. A company representative told him the helicopter ride would most likely cost more than $50,000 and asked him how he planned to pay.

For Khan, rapid transportation to the trauma center was essential since the blood supply to his arm had been cut off, said Dr. Rajesh Gandhi, the medical director for trauma services at JPS Hospital.

“If there’s no blood going that means there’s no oxygen,” he said. “It there’s no oxygen, that means those cells are going to die.” Minutes are precious and the helicopter can get from Wichita Falls to Fort Worth in an hour or less, half the time it takes by ground ambulance, he said.

But complaints about sky-high bills to patients for air ambulance services are common. Since launching the “Bill of the Month” series in February, NPR and Kaiser Health News have received more than a dozen bills from patients like Khan who were charged tens of thousands of dollars for an air ambulance ride even after insurers’ payments.

Air ambulance companies defend their charges.

Rick Sherlock, president of the Association of Air Medical Services, a trade group, said air ambulances require a more highly trained crew than a ground ambulance, because only the sickest or most seriously injured patients need air transport.

AAMS commissioned a study to determine the actual cost of a medevac ride. The report found it takes about $2.9 million a year to run a single helicopter base. Each base handles about 300 transports a year, and the rides cost about $11,000 each, according to the report.

A spokeswoman for Air Evac Lifeteam said the company bills people so much because it is trying to make up for what she said are meager payments from Medicare and Medicaid.

“Our real cost per flight is the $10,200 plus the unreimbursed cost on each flight for Medicare, Medicaid and patients without any coverage,” wrote Shelly Schneider, the company spokeswoman.

The Centers for Medicare & Medicaid Services said it pays an average of $4,624 per ride, plus $31.67 a mile, which works out to an average Medicare reimbursement of $6,556 for helicopter ambulance rides for seniors. Medicaid in most states pays less.

The industry has been advocating hard to get Medicare to boost its reimbursements, Sherlock said. There are bills pending in both the House and Senate that would do so, but there hasn’t been much movement on them.

But others say the industry’s cost estimates are inflated by profit-driven expansion of a lucrative industry. Ground ambulances often carry critically ill patients, too.

Too many air ambulances sit idle much of the time, said Dr. Ira Blumen, a professor of emergency medicine at the University of Chicago and medical director of the university’s Aeromedical Network.

Blumen said the industry — which is dominated by a few companies owned by private equity firms — expanded dramatically in 2002, the last time Medicare boosted its payments. And now there are too many helicopters — 908 as of last year — fighting for patients and profits at the same time.

“The number of helicopters is outrageous for the continental United States,” he said. In the 1990s, most helicopters ran more than 500 flights per year on average. At that rate, the cost per flight today would be less than $6,000.

A BCBS of Texas spokesman said the insurer does have a contracted rate with an in-network air ambulance company, but it is not Air Evac Lifeteam. After initially refusing to pay anything for an out-of-network claim, it agreed to the $11,972 payment.

But in some sense, the reason ambulance companies charge so much is simply that they can: Air ambulances are largely regulated not as health care but as part of the aviation industry. Federal laws prevent states from limiting aviation rates, routes and services.

So many people have been hit with shockingly high air ambulance bills that members of Congress on both sides of the aisle are trying to do something about it. Legislation to reauthorize funding for the Federal Aviation Administration that is moving through Congress now would create a council of industry experts to address balance billing and other issues and set up a complaint line for consumers.

Resolution: Khan has allowed Air Evac Lifeteam to negotiate with BCBS of Texas over the remaining $44,000-plus air ambulance bill. The company has asked him to appeal to the state’s Department of Insurance, and though he first balked at the suggestion, he is now considering doing so. Khan said he doesn’t understand why the helicopter flight, which was an integral part of the emergency medical care he received, is treated differently from his surgeries, nursing care and physical therapy.

“I thought that this was another piece of that puzzle,” he said. “It turns out that this was glaringly different.”

He is waiting for resolution as he gets accustomed to life with his disability. Holding his baby son, he asked in frustration: “How do I hold him while he’s crying and at the same time heat up his bottle?”

Khan, who has had to fight with his insurance company to get coverage for a prosthetic arm, was frustrated when he learns that the air ambulance company expects him to pay far more than the actual cost of his flight.

“It’s unfair,” he said. “It’s random; it’s arbitrary. It’s whatever price they want to set. And to put that onto a person who’s already been through what I’ve been through, I hate to say it, but it’s cruel.”

The takeaway: Most people with health problems serious enough to require a helicopter flight are in no position to ask whether the medevac company is in-network or there’s a choice. But if you or a family member has time to ask, it could pay off.

If you’re faced with a huge bill for a medevac ride, there are a few steps you should take.

First, let your insurer’s process play out. BCBS of Texas first denied Khan’s claim altogether. But he looked closely at his policy and saw that the threat of loss of limb was explicitly covered. He appealed, and that’s when the insurer paid $11,972.

Second, negotiate! The air ambulance company might be willing to negotiate a settlement for a fraction of the bill to avoid turning to debt collectors, who would pay them pennies on the dollar.

Both Sherlock of the Association of Air Medical Services and Schneider of Air Evac Lifeteam said companies will try to determine what a patient can afford. So people with high incomes may find it hard to obtain a substantial reduction for their bill. Still, if patients know the true cost of the service they received, they may be better equipped to negotiate a discount.

Many air ambulance companies offer membership plans that can cost less than $100 a year and guarantee that the company will accept whatever payment an insurance company makes without billing the patient for the rest. But buyer, beware: When people need an air ambulance, they are often not in a position to choose which company will respond to the call.