Lifeteam EMS

Sta 1 P.O. Box 362

740 A Dresden Ave.

East Liverpool, OH 43920

 

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330-386-5505  •  330-385-0000

Business Line: 330-386-9284

When seconds count…… you can count on Lifeteam!

 

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LIFETEAM EMS Ambulance Service - Membership Plans: 

The Family Plan:

The Family Plan is an ambulance service agreement

from LIFETEAM EMS, Incorporated.  The Family Plan

provides reduced fees for emergency and non-emergency

ambulance transports. The Family Plan is not an insurance

policy or supplement. Your insurance carrier makes all

determinations concerning medical necessity.

 

Who is covered:

A Family Plan membership can include the applicant and

immediate family members living at the same address

(i.e. spouse, unmarried dependent children up to age 21 or

age 25 if a college student). A spouse or dependent child

residing at a nursing facility will also be covered under

the Family Plan.

 

Services:

The Family Plan provides coverage for emergency and non-emergency ambulance transports. Patient preference usually determines the hospital to which the patient is transported. However, in a life endangering situation, the closest appropriate facility should be used. When service is rendered, LlFETEAM EMS will bill the member's insurance carrier. If the insurance carrier accepts the ambulance transport as medically necessary, and accepts the destination as appropriate, LlFETEAM EMS will accept the insurance payment as payment in full once the member has fulfilled any deductible obligations. If the insurance carrier accepts the transport for payment but denies the mileage charge because of the destination, the member will be responsible for the difference in the mileage charge due and the mileage charge paid by the insurance company. If there is no insurance coverage, or the insurance company denies payment for services, the member will remain responsible for the cost of service, but at a reduced rate.

 

Excluded Services:

The following destinations are not covered by Medicare, and most private insurance policies: Doctor's offices, dentist's offices or therapy centers. The FAMILY PLAN does not cover transports to these destinations either. The FAMILY PLAN does not provide coverage for Ambulette/Wheelchair Van transports. MEMBERSHIP FEE: $25 per year $20 per year (if members are over age 65)

 

Agreement:

In consideration and payment of the FAMILY PLAN membership fee, I hereby assign to LlFETEAM EMS, Inc. all ambulance benefits that I or any covered family member may otherwise be entitled to receive for service provided by LlFETEAM EMS, Inc. under my FAMILY PLAN Agreement. I understand that LlFETEAM EMS will file my insurance claim and that I will provide LlFETEAM EMS with all pertinent information pertaining to such claim. If no benefits are available or the services are denied, I understand that I will remain responsible for the bill. I further understand that any insurance benefits that I receive, that are related to services provided by LlFETEAM EMS, shall be immediately submitted to LlFETEAM EMS.

 

For More Information:

If you would like to have a membership plan application mailed to you, please

email using the form provided.

Membership Information Request: 

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