Written by a parent, not a doctor. Nothing here is medical advice.

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California program

Limits on ground ambulance bills (AB 716)

California limits on some ground-ambulance bills for people with state-regulated plans or no insurance.

What it is

California limits on some ground-ambulance bills for people with state-regulated plans or no insurance.

California can limit a ground-ambulance bill where federal surprise-billing law does not. Which protection applies depends on your coverage and the bill. Private self-funded plans need their own terms checked.

Who can get it
  • The insured protection applies to DMHC- or CDI-regulated fully insured plan contracts issued, amended or renewed on or after January 1, 2024.
  • For covered services under the California-regulated commercial plans reached by this law, an out-of-network ground ambulance cannot charge more than the in-network share. Medi-Cal health plans use their own billing protections instead. Private self-funded work plans are generally outside the commercial rule. Public-employer and other unusual plans need their own document check.
What you get
  • Eligible insured patients owe only their in-network share for an out-of-network ground ambulance.
  • Uninsured or self-pay charges cannot exceed the higher Medi-Cal or Medicare rate.
What you get
  • An eligible plan member owes no more than the in-network cost share for an out-of-network ground ambulance.
  • The uninsured cap is the higher of the Medi-Cal payment or Medicare rate.
If you decide to apply
  1. Ask the health plan to review the ambulance bill and explanation of benefits if you want the charge checked.
  2. For an uninsured or self-pay bill, ask the ambulance billing office to compare it with the legal rate cap.

Plan or ambulance billing office; DMHC: 888-466-2219; CDI: 800-927-4357 · Official page ↗

What happens next
  • A corrected bill should show the applicable member share or uninsured cap.
  • Continued billing above an applicable cap can be raised with the plan’s regulator.
Good to know

Private self-funded work plans are outside the automatic state protection. Federal surprise-billing law also excludes ground ambulances.

What else to know
  • A Medi-Cal member’s ambulance claim belongs with Medi-Cal. The plan can review a bill sent to the family.
  • Federal protections for air ambulances do not establish ground ambulance protection.
Official sources
Ask your social worker

“If we receive a ground-ambulance bill, which cap, if any, applies under our coverage? What might we still owe? Would a billing review help, and could you help us request one?”

Why I’m asking: I want to understand what we owe if an ambulance bill arrives.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Do not pay the bill as sent. Send it to the plan, ask for the in-network share, and quote the cap to the ambulance company.

Your social worker

The financial counselor can tell you whether the transport was billed to the plan and by whom.

The care team

Records and letters when the application asks for them.

Who decides
The health plan for the member share; the ambulance provider for the uninsured cap
Ask the billing office
“This ambulance bill is above our in-network share. Under California law we owe only that share. Can you rebill the plan and confirm the balance?”

How to apply

First step: When an ambulance bill arrives, send it to the plan and ask in writing for your in-network share. Keep the bill.

  1. Send any ambulance bill to the plan and ask for the in-network share in writing.
  2. If uninsured, ask the ambulance company for the Medi-Cal or Medicare rate.
  3. Complain to DMHC or CDI if the billing continues.

Where it starts: Send the bill to the plan; complain to the regulator if the ambulance keeps billing

What to gather

  • The ambulance bill
  • The plan's explanation of benefits for the trip

How long: The plan reprocesses on request. A regulator complaint follows if it does not.

What a yes looks like

A corrected bill at the in-network share, or at the Medi-Cal or Medicare rate if uninsured.

What a no looks like, and the next move

The ambulance company keeps billing the full amount. File with DMHC or CDI and ask the hospital's financial counselor for help.

Watch out

  • Self-funded work plans are outside this rule, and the federal surprise-billing law leaves ground ambulances out. Ask the plan what it pays.
  • A Medi-Cal child: the ambulance company bills Medi-Cal. Send any bill to the plan.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

Out-of-network ambulance: only the in-network cost share. Uninsured: no more than the Medi-Cal or Medicare rate.

Legal protection: A member of a state-regulated plan owes an out-of-network ground ambulance no more than the in-network cost share (plan contracts from January 1, 2024) · An uninsured or self-pay patient is charged no more than the Medi-Cal payment or the Medicare rate, whichever is higher

What it costs the family: The in-network share, or the capped rate.

The eligibility facts, as published

Plan
fully insured plan regulated by DMHC or CDI, contract issued, amended or renewed on or after 2024-01-01
Uninsured
uninsured or self-pay patient
Self funded
not automatic; plan-specific protection unknown

Decisions this site cannot make: Plan type · Ambulance provider's billing

Expect friction on: Ambulance billers rarely know the rule

The trap: Paying the ambulance bill as sent. Send it to the plan first and ask for the in-network share.

Where I read this

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