The No Surprises Act and air ambulance bills

Reviewed by the AirAmbulance.org editorial team · Updated 20 October 2026 · Editorial policy

Since January 1, 2022, the No Surprises Act protects many people with health insurance from surprise out-of-network air ambulance bills. Here's what it covers and what to do.

What it covers

• Air ambulance flights (helicopter and fixed-wing) for people with group or individual health insurance.
• You pay only your in-network cost-sharing, even if the air ambulance was out of network.
• The provider and insurer settle the rest between them.

What it doesn't cover

• Ground ambulances are not covered by the federal law (some states have their own rules).
• Medicare and Medicaid already have their own billing protections.
• People without health insurance have different protections.

If you get a surprise bill

• Check your explanation of benefits from your insurer before paying anything.
• Ask the provider whether the No Surprises Act applies to the bill.
• Contact your insurer, and if needed the federal No Surprises Help Desk, to dispute it.

General information only, not medical, legal or insurance advice. Rules, coverage and prices change; confirm with your provider and insurer.