American Legion Tickets Available at Payless IGA

AMERICAN LEGION POST 108 AMBULANCE SERVICE SUBSCRIPTION PROGRAM

COST

·  The cost of the annual ticket subscription is fifty dollars. ($50.00)

·  For active members of The American Legion the cost of the annual ticket subscription is thirty dollars ($30.00).

COVERAGE

·  Ticket covers spouses and legal dependents only. (NO EXCEPTIONS).

·   Subscribers must be residents of Amador or Calaveras Counties. Transports for ambulance service must originate or terminate within Amador or Calaveras Counties.

·  Ambulance transports are limited to 60 miles which covers Sacramento, Stockton and Modesto Areas. Transports over the 60 mile limit will be billed for mileage greater than 60 miles.

·  All qualified patients (meaning those persons whose doctor has designated the trip as a “medical necessity”, or who are “bed confined”) are covered.

TICKET TERM

·  The ticket is valid for one calendar    year from date of purchase.

DUTIES OF AMBULANCE SERVICE

·  American Legion Ambulance service will accept the assignment of whatever insurance patient possesses as full payment for services rendered, regardless of the amount of coverage or charges.

·  American Legion Ambulance service will use all reasonable steps to provide the transportation as requested unless conflicting circumstances ( e.g., prior response to emergency, etc.) prevent it.

DUTIES OF PURCHASER OF TICKET

·  Subscriber agrees to pursue in good faith all claims available to him/her for reimbursement of all of the ambulance service charges incurred by subscriber and agrees to furnish all insurance information to ambulance service and to process claims promptly.

·  Subscriber agrees to assign all interest in his/her claim for recovery of ambulance costs to American Legion Ambulance and hereby grants a lien to American Legion Ambulance on any recovery received, for the amount of the ambulance charges.

·  Upon such assignment and granting of a lien, American Legion Ambulance agrees to accept whatever amount is recovered as full payment of the ambulance charges.

·  Subscriber agrees that upon failure of subscriber to follow the above terms, American Legion Ambulance may, at its sole discretion, revoke this subscription; reimburse the price of the subscription and demand full payment for all services rendered.

NOTICE

·  Medicare prohibits Ambulance Services from waiving co-payments and deductibles.

·  American Legion Ambulance does NOT GUARANTEE performance under this agreement, but agrees to make best efforts to perform as circumstances permit.

PERSONS WITHOUT AMBULANCE TICKETS

·  American Legion Ambulance bills the insurance carrier for all charges incurred for the patient. If there is no insurance or if the insurance does not cover all or any portion of the bill, the patient is responsible to pay the unpaid bill.

MEDI-CAL

·  Medi-cal recipients do not require an Ambulance Ticket.