Cal-Ore Life Flight has over 22,000 participants who enjoy the peace of mind membership provides. Combined ground
and air memberships are available to all interested parties. In addition, member
or not, residents throughout Northern California and Southern Oregon can preselect
Cal-Ore as their air ambulance provider.
A Cal-Ore Life Flight (“Company”) membership ensures the patient will have no out-of-pocket flight expenses if flown by the Company or another AirMedCare Network participating provider (together with the Company, each an “AMCN Provider”) by providing prepaid protection against AMCN Provider emergent air ambulance costs that are not covered by a member’s insurance or other benefits or third party responsibility, subject to the following terms and conditions:
Patient transport will be to the closest appropriate medical facility for medical conditions that are deemed by AMCN Provider attending medical professionals to be life- or limb-threatening, or that could lead to permanent disability, and which require emergency air ambulance transport. A patient’s medical condition, not membership status, will dictate whether or not air transportation is appropriate and required. Under all circumstances, an AMCN Provider retains the sole right and responsibility to determine whether or not a patient is flown.
AMCN Provider air ambulance services may not be available when requested due to factors beyond its control, such as use of the appropriate aircraft by another patient or other circumstances governed by operational requirements or restrictions including, but not limited to, equipment manufacturer limitations, governmental regulations, maintenance requirements, patient condition, age or size, or weather conditions. FAA restrictions prohibit most AMCN Provider aircraft from flying in inclement weather conditions. The primary determinant of whether to accept a flight is always the safety of the patient and medical flight crews. Emergent ground ambulance transport of a member by an AMCN Provider will be covered under the same terms and conditions.
Members who have insurance or other benefits, or third party responsibility claims, that cover the cost of ambulance services are financially liable for the cost of AMCN Provider services up to the limit of any such available coverage. In return for payment of the membership fee, the AMCN Provider will consider its air ambulance costs that are not covered by any insurance, benefits or third party responsibility available to the member to have been fully prepaid. The AMCN Provider reserves the right to bill directly any appropriate insurance, benefits provider or third party for services rendered, and members authorize their insurers, benefits providers and responsible third parties to pay any covered amounts directly to the AMCN Provider. Members agree to remit to the AMCN Provider any payment received from insurance or benefit providers or any third party for air medical services provided by the AMCN Provider, not to exceed regular charges. Neither the Company nor AirMedCare Network is an insurance company. Membership is not an insurance policy and cannot be considered as a secondary insurance coverage or a supplement to any insurance coverage. Neither the Company nor AirMedCare Network will be responsible for payment for services provided by another ambulance service.
Membership starts 15 days after the Company receives a complete application with full payment; however, the waiting period will be waived for unforeseen events occurring during such time. Members must be natural persons. Memberships are non-refundable and non-transferable.
Some state laws prohibit Medicaid beneficiaries from being offered membership or being accepted into membership programs. By applying, members certify to the Company that they are not Medicaid beneficiaries.
These terms and conditions supersede all previous terms and conditions between a member and the Company or AirMedCare Network, including any other writings, or verbal representations, relating to the terms and conditions of membership.
"A Word from the California Department of Managed Health Care"
(A) "BEFORE YOU PURCHASE: If you are currently enrolled in a Health Maintenance Organization
(HMO) or other Health Insurance, the benefits provided by your HMO or other Health Insurance. If
you have a question regarding whether your HMO or other Health Insurance offers benefits for ambulance
services, you should contact that other company directly."
(B) "WARNING: This Ambulance Plan is not an insurance program. It will not compensate or reimburse
another ambulance company that provides emergency transportation to you or your family. This may occur
when the 911 Emergency System has independently determined that another company could provide more
expeditious service or is next in the rotation to receive a call. This might also occur when the
Ambulance Plan is unable to perform within a medically appropriate time frame due to a mechanical
or maintenance problem or being on another call."
(C) "COMPLAINTS: For complaints regarding Cal-Ore Life Flight, first attempt to call us
at 1-800-761-5183. If Cal-Ore Life Flight fails to resolve the complaint to your satisfaction, contact
the Department of Managed Health Care at 1-800-400-0815. The Department's website is
http://www.dmhc.ca.gov. You may obtain complaint forms and instructions online."
(D) "OPERATING UNDER CONDITIONAL EXPEMPTION: Cal-Ore Life Flight is operating pursuant to an
exemption from the Knox-Keene Health Care Service Plan Act of 1975 (Health and Safety Code section 1340
Please Note: Information contained herein
subject to change without notice.