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Frequently Asked Questions


Why is the hospital sending me a bill for Ambulance Service?

All patients, except those listed in the Special Exemption categories, who receive land ambulance transportation, pay a co-payment for the ambulance services rendered. In most cases, hospitals act as the billing agents, although occasionally bills may be issued by the ambulance service provider.

What am I charged if an ambulance arrives to assist me but does not transport me to the hospital?

Patients may decline ambulance transport by requesting to sign a Refusal of Service form provided by the attending paramedics. Patients declining transport by signing the Refusal of Service form are not billed for paramedic services rendered at the scene.

Why was I billed $45 for ambulance service?

When an Ontario citizen with a valid health card is transported within Ontario by land ambulance, and the use of the ambulance is deemed medically necessary, under legislation he or she is required to pay the billing institution a co-payment of $45 unless falling into one of the Special Exemption categories.

Why was I billed $240 for ambulance service?

When an Ontario resident with a valid health card is transported within Ontario by land ambulance, and the receiving hospital physician or designate deems the use of an ambulance medically unnecessary, the ambulance transportation is not insured under the Ontario Health Insurance Act and the patient must pay the billing institution $240.

What are the Special Exemption categories?

All Ontario citizens who travel within Ontario by ambulance for medically necessary services, and who have a valid Ontario Health Card, are required to pay a portion (co-payment) of the ambulance services rendered in the amount of $45, except under the following situations:

  • the person receives benefits under the Ontario Works Act, the Ontario Disability Support Program Act, or the Family Benefits Act;
  • the person receives provincial social assistance (general welfare assistance or family benefits);
  • the person is being transferred from one health facility to another for insured, medically necessary treatment;
  • the person is enrolled in the ministry's Home Care Program;
  • the person is living in one of the following facilities licensed or approved by the Ministry of Health and Long-Term Care:
  • nursing home
  • home for the aged
  • rest home
  • home for special care
  • home or residence for psychiatric patients.

Who decides if my ambulance use was medically necessary?

The receiving hospital's physician (or designate) makes this determination. For the purposes of billing, paramedics are not empowered to determine whether a patient's land ambulance transportation is medically necessary or not.

I received transportation by a service that appears to be an ambulance but the bill is substantially larger than the co-payment fees described above. Why?

In order to ensure that ambulances remain available to service emergencies, many municipalities utilize third-party non-ambulance medical transport services. Non-ambulance medical transport providers are private firms capable of transporting patients who are not in an emergency situation.

On occasion these non-ambulance service providers may be requested to provide transport for patients and may issue bills that exceed the land ambulance co-payment fee. Concerns regarding such bills should be directed to the provider of the non-ambulance transport service, the hospital arranging for the service, or to the municipality responsible for contracting for service with the non-ambulance provider.

I received ambulance service along with another member of my family and both of us were charged the ambulance co-payment fee. Why?

Regulations made under the Health Insurance Act specify that each person transported in an ambulance is responsible for the payment of appropriate ambulance co-payment charge. Therefore each patient transported, regardless of the distance or number of patients in the ambulance, is responsible for the payment of the costs set out in the legislation.

Who do I contact if there is an expected death in the family and we do not require EMS to come to the scene?

In the unfortunate case where an expected death has occurred, the first person to call should be the physician who has been caring for your loved one. After doing this, it is recommended to contact the Funeral Home that you have chosen in your expected death preparations.

What is an offload delay? Why do the paramedics sit in the hallways of the ER?

An offload delay occurs when the paramedics bring in their patients to the ER and the charge nurse is either with another paramedic and their patient or they are occupied at the time of arrival. The charge nurses are aware of what patients are coming in by ambulance and will be available to assist immediately with urgent patients. Paramedics are sometimes waiting in the hallways of the ER due to a shortage of beds. Our service uses the same triage scale as the hospital, and patients are put in order based on nature of problem and severity. The less urgent the case, the longer they may wait. The paramedic is responsible for the patient until they are transferred over to the hospital staff.

Why are there ambulances sitting in parking lots?

When you see an ambulance parked in a parking lot or vacant space, they are usually on what is called a standby. A standby is when an ambulance has to cover a larger area than they normally would with additional units. These locations are strategically identified to provide optimum coverage and response times during a high call volume time.

What can I do to expedite the process of transport for EMS?

If you ever have to call 911, while waiting for paramedics to arrive you could do some simple things to make the process go smoother and quicker:

  • Make sure there are no vehicles in the way, or in the driveway where the ambulance needs to back in.
  • Clear snow from steps, sidewalk, driveway, etc.
  • Remove obstacles, rugs or mats in the path to the patient.
  • Gather patient's medications and ensure health card is handy for the hospital clerks.
  • Secure any pets prior to EMS arrival
  • If the patient has a Do Not Resuscitate Order (DNR) have this ready

Why does an ambulance pass me with lights and sirens on and then once they pass through the intersection or lights they turn them off?

Sometimes while responding to a call when lights and sirens are required, the call can be downgraded, in which lights and sirens are no longer required; or the call could have been cancelled completely.

If I call an ambulance, will I be seen by a doctor sooner?

No. Essex-Windsor EMS uses the same triage scale as the hospital. The triage scale works by measuring the severity of the patients needs. Sometimes patients that come by ambulance can be placed in the waiting room if determined by hospital staff.

Why won't the ambulance take me to the hospital of my choice?

Depending on the scenario, paramedics are required to take certain patients to a certain hospital. Some hospitals are designated for certain illness/injuries.