One Coronado resident is wary of calling an ambulance again after she incurred a $6,100 bill for her two-and-a-half block ride to Sharp Coronado Hospital.
In comparison, the city of San Diego’s current fee for transport is just under $3,000, and Poway’s fee is $5,400.
But the price of an ambulance ride isn’t cheap, and the city is looking to recover some of the costs for the service as it doesn’t receive state or federal government funding. The fire department, and in turn, ambulance services, are fully funded by the city’s general fund.
However, the current fee is 350% more than the previous fee of $1,350 – which had been Coronado’s rate since 2010, until it was raised in 2024.
Coronado doesn’t contract with a third-party ambulance service, according to Coronado’s Fire Chief Jayson Summers. Coronado’s ambulance service is the city’s Fire Department with its 19 firefighter-paramedics.
As of last year, the city charges over $6,100 for an ambulance ride, which is the actual cost to provide that service. This includes salaries, benefits and administrative overhead.
A Coronado resident’s experience
And that’s the cost Coronado resident Connie Peacock, 70, had to pay when she thought she was suffering a heart attack in January. She lives less than three blocks away from the hospital.
They took good care of me … I’m very grateful for that, and fortunately, I didn’t have a heart attack. But I tell you, (the cost) did scare me.
Coronado resident Connie Peacock
“They took good care of me … I’m very grateful for that, and fortunately, I didn’t have a heart attack,” Peacock told The Coronado News. “But I tell you, (the cost) did scare me.”
A few months ago in August, Peacock fell down a flight of stairs and instead of calling 911, she had her son drive her to the hospital.
She had three fractures in her back, a fractured sternum, a concussion and a brain bleed from the fall.
Peacock said it’s scary to think that people would hesitate to call 911 and instead take a car to the hospital to avoid a large bill. If she had sustained worse injuries, picking herself up and figuring out her own way to the hospital could have been worse for her, she said.
It took her several months to figure out her invoice, and it wasn’t until after her accident in August that she found out her insurance would cover the entire ambulance bill.
For persons without insurance, a new law that took effect in January 2024 offers some protection. Assembly Bill 716 limits self-pay patients’ bills to no more than what Medi-Cal or Medicare’s fees are.
Updated ambulance fees
In September 2024, Summers presented a study of ambulance fees, conducted by Willdan Financial Services, to the City Council.
There had not been an updated fee study for Coronado since 2010.
In the report, the city outlined two separate classifications for emergency medical calls. Advanced life support, or ALS, covers conditions like a heart attack or serious trauma, while basic life support, or BLS, would cover minor injuries or illness.
The study provided a brief explanation of the costs behind the city’s $6,100 ALS and $5,500 BLS price tag for an ambulance ride.
Summers said it was important to note that ambulance fee studies are not often conducted, so any cities within San Diego County that still have low ambulance rates might be due to dated studies.
The report said that in 2023, 60% of emergency calls in Coronado were for ALS. At the time, ambulance transport fees were set at $1,350 for ALS and BLS calls were set at $1,200.
It also showed that Coronado’s ambulance fees were the lowest in the region, with some cities like La Mesa and Lemon Grove exceeding $3,000 per ride.
Through the fiscal year 2023-2024, the fire department had over 1,300 transports, projected to generate a total of $780,000. However, it said the cost to provide those services was over $12 million.
Cost recovery for the city
The previous fee of $1,350 was supposed to represent 22% of the total cost of operating the ambulance transport that goes back to the city. However, the actual cost recovery only ended up being somewhere between 6% and 14%, despite the 22% that was being charged to residents.
The study cited fee collection limitations, noting that federal and state programs such as Medicare and Medi-Cal set maximum reimbursement rates for ambulance transports. This means that the city cannot legally bill more than the capped amounts.
Medicare and Medi-Cal sets “caps on how much a provider can be reimbursed for administering services and private insurances pay a percentage of the costs billed … these fee limits make full cost recovery infeasible,” the report states.
So even though the city was charging $1,350, it wasn’t getting all of that.
In order to increase their cost recovery, Coronado City Council members voted to charge 100% of the total cost to provide the service. That meant that with the fee collection limitations, the cost recovery for the city would be anywhere between 26% and 34% – more than 20% of what the city saw previously.
