SUBSCRIPTION PROGRAM TERMS AND CONDITIONS
The subscription program offered by Penndel-Middletown Emergency Squad (hereinafter referred to as “PMES”), a 501c3 non-profit organization, is primarily designed to provide funding to assure the 24-hour availability and delivery of high quality, emergency medical services and other medical transportation services.
The funds collected from the subscription program are used by PMES to offset costs associated with purchasing and equipping emergency vehicles, staffing, and training of emergency medical providers and other related administrative, overhead and system costs.
Residents of the following municipalities are eligible to subscribe:
Middletown Township, Hulmeville Borough, Langhorne Borough, Langhorne Manor Borough and Penndel Borough.
Subscribers receive the benefit of unlimited access to basic and advanced life support, emergency ambulance service, throughout the coverage area, when PMES is available to respond throughout the term of the subscription year.
All subscriptions expire on June 30th of each respective calendar year, regardless of the date when a subscription is paid.
The subscription program is neither an insurance contract nor a solicitation of insurance premiums. This is also not a solicitation to persons receiving medical assistance benefits.
Subscribers agree and understand that PMES reserves the right to bill its reasonable and customary charges relating to all services rendered to subscribers by PMES - to all available reimbursement sources. The payors of ambulance service may include the subscriber and/or their primary and secondary insurance carriers including federal health care programs (excluding Medicaid) and other commercial insurance carriers, as permitted by law, and are responsible for all charges associated with services provided under this subscription program.
Insurance payments, if any, are applied to the subscriber’s balance. Once all insurance payments are applied, subscribers receive a 50% discount on any remaining out-of-pocket expenses (including deductibles, co-payments, etc.) related to medically necessary emergency ambulance services, provided by PMES, to the closest appropriate medical facility.
Subscribers are entitled to unlimited emergency medical services, as described herein, within the PMES coverage area.
The FAMILY SUBSCRIPTION PLAN is designed for households which contain two or more individuals. Family coverage encompasses all residents including legally defined dependents of the household. Subscribers must maintain a primary residence within the ambulance coverage area.
The SENIOR COUPLE SUBSCRIPTION PLAN covers no more than two (2) individuals who reside in the same household and are 65 years of age or older. Subscribers must maintain a primary residence within the ambulance coverage area.
The INDIVIDUAL AND SENIOR INDIVIDUAL SUBSCRIPTION PLANS covers only the individual named on the subscription application. Subscribers must maintain a primary residence within the ambulance coverage area.
Emergency subscription coverage becomes effective, upon receipt and acceptance of the subscription application by PMES.
PMES, in consultation with medical command physicians, reserve the exclusive right to make all decisions regarding medical transportation services and the destination provided to all patients, including subscribers. These decisions will be made based primarily upon the patient’s medical condition at the time of service and applicable laws of the Commonwealth of Pennsylvania and other regulations as promulgated by the Pennsylvania Department of Health.
Secondary considerations include but are not limited to patient or family requests, the capability and availability of relevant medical services at a receiving medical facility, current policies and procedures and the availability of EMS system and hospital resources.
During limited times, when all available PMES resources are in use, PMES may be unable to respond and provide complete emergency services to a subscriber or 911 request, within its primary ambulance coverage area. Examples of these circumstances are basic or advanced life support treatment (including paramedic assists) and/or other emergency transport related services - when all available PMES resources are already in use. During these limited time periods, another ambulance service may be called upon by PMES and/or 911 center to provide “mutual aid” assistance including basic and advanced life support or other EMS related services including paramedic assists. (Paramedic assist services are defined as an incident in which PMES provides basic life support and/or transport services and another mutual aid organization provides the necessary advanced life support components of care including paramedic assessment and ALS treatments.
As PMES has no direct control over which mutual aid service will be sent as mutual aid resources, the subscriber may be responsible for payment of certain charges set forth by mutual aid organizations.
To help reduce subscriber payment liability for mutual aid services, PMES has entered into reciprocity agreements with a number of local mutual aid organizations. However, please note that subscription reciprocity coverage is not available from all local mutual aid services.
Subscribers are also required to fully cooperate with designated billing representatives authorized by PMES in their efforts to collect any lawful reimbursement associated with the provision of emergency medical services, non-emergency ambulance services or other applicable services rendered by the ambulance service to subscribers.
Subscribers are required to furnish all insurance numbers, authorizations and other information needed by PMES to submit an insurance claim to all applicable insurance carriers.
Subscribers are required to immediately remit to PMES all reimbursement immediately upon receipt from any source including commercial or governmental agencies or any other third-party insurance carrier or program for services provided under the terms and conditions of the subscription program. Subscribers agree to forward to the ambulance service, within 5 days of receipt, all payments received for services rendered by the ambulance service during the subscription year.
Subscribers who fail to forward payments received from other sources further agree to be responsible for all legal or collection fees incurred by the ambulance service in order to recover all reimbursement received by the subscriber related to the provision of subscription related services including all related costs, fees and interest.
Subscribers may also be required to notify their insurance carrier(s), their primary care physician or other applicable parties about services rendered by PMES to obtain authorization for payment of benefits directly to PMES. Whenever possible, PMES will send invoices directly to the insurer or other medical benefits provider.
Subscribers receiving ambulance and other related services will be asked to assign all rights and benefits from any applicable insurance program or medical benefits, to PMES for services rendered throughout the term of the subscription year.
Subscribers will be asked to authorize and direct all reimbursement including all reimbursement received from any applicable insurer(s) or medical benefits provider(s) to be paid directly to PMES.
Subscribers are responsible for payment of all charges for services rendered in good faith by PMES but are later determined to be a non-covered service or denied by the subscriber’s insurance carriers for any reason.
Subscriptions become null and void if subscriber relocates their primary residence to an area which is located outside of the PMES coverage area.
Subscription fees, along with usual and customary fees for ambulance and other services provided by PMES are established exclusively by PMES and are subject to change without written notice.
Subscription coverage applies only to persons who accept and comply with the terms and conditions outlined in this agreement.
Subscriptions are non-refundable, non-transferable and may be revoked at the sole and exclusive discretion of PMES.
PMES exclusively reserves the right to change all subscription and/or service fees, and the content of these subscription terms and conditions, at any time, without prior written notice or approval by subscribers.
effective 7/1/2022