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NY Man Gets $656,063 Air Medical Bill - Not a misprint

DeWitt, NY — A 61-year-old DeWitt man feared he’d die after suffering a heart attack aboard a cruise ship more than 1,000 miles from a Florida port.

As reported by, Robert Shapiro said once he got to nearby British Virgin Islands, doctors recommended he take an emergency medical flight because they had no cardiologist, its hospital decimated by a 2017 hurricane. Doctors on the 24,000-person island worried he might have a blocked artery, which could cause stroke or worse, Shapiro said.

“At the time, we thought it was life and death,” Shapiro told | The Post-Standard recently. “I’m going to sign whatever they give me to get going.”

That started with a $36,000 retainer fee to REVA air ambulance, which Shapiro willingly paid with his credit card after calling his insurance company.

Fortunately, it turned out that Shapiro’s heart attack in April 2018 was more scare than a true emergency. But, he says, the bigger pain came later.

Excellus Blue Cross Blue Shield refused to repay Shapiro for any part of the 1,800-mile trip home to Syracuse. Shapiro said an Excellus rep had promised beforehand that the air ambulance bill would be covered.

“We didn’t have anything in writing,” Shapiro acknowledged. “We’re on a cruise, in the middle of an island. No laptop, no email.”

Things got worse when the air ambulance then billed his insurance — which denied coverage — for a whopping $656,063.


“I figured it was a misprint, but it wasn’t,” Shapiro said of the astronomical figure. “You could buy a plane for what they charged.”


The insurance company, which had already balked at paying for Shapiro’s trip, sent him a notice insisting he faced the bill for two-thirds of a million dollars.

“Am I responsible for the whole thing?” Shapiro wondered. “The $36,000 was just a retainer.”

In late May, Shapiro filed a lawsuit against Excellus on two fronts: demanding the insurer repay him $36,000 for his out-of-pocket air ambulance fee and to expunge the $656,063 bill.

“They turned down the entire trip,” he said. “They wouldn’t even pay to get me from the island to Fort Lauderdale (about half of his out-of-pocket costs). They should be ashamed of themselves.”

$656,063 is a real bill

Air ambulance companies know they have patients over a barrel when doctors or first responders recommend an emergency flight.

There’s a trip insurance industry that promises to pay for such emergencies, on cruise ships and in foreign lands. But Shapiro says his health insurance covered such emergencies — and, he added, the global Blue Cross rep he contacted confirmed that.

Consumer Reports noted the average cost for a U.S. air ambulance topped $50,000 in 2016. For those on Medicare or Medicaid, the government only pays between $200 and $6,000 per transport. That leaves those on private insurance with exorbitant bills to make up the difference, a trade group president told Consumer Reports in 2017.

    2 replies to "NY Man Gets $656,063 Air Medical Bill – Not a misprint"

    • Avatar Skip Kirkwood

      In an emergency situation, “medical necessity” should be based on what is known at the time of the event – not after all is said and done, the studies, the cath lab, etc. Looking at the event through the retrospectoscope is all wrong.

      • Avatar Troy Shaffer

        Hi Skip Kirkwood,

        I agree with you and I think it should be easy to agree with your perspective. I’m cautiously optimistic we’re moving in this direction.

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