Because of a law passed by the state legislature in 2017, North Dakotans will have some protection against expensive bills from out-of-network air ambulances.

North Dakota Insurance Commissioner Jon Godfread wants consumers to be aware of the new law, which went into effect Jan. 1 and is “designed to protect consumers from massive, unexpected air ambulance bills.”

When out-of-network air ambulances are required, the billing is often split between the patient and provider. Over a four-year span starting in 2013, the North Dakota Insurance Department received 34 complaints totaling $1.86 million in charges for air ambulance services, according to a press release issued by the department. The average cost was $54,705 per ride with billing amounts as high as $66,000.

The law passed by legislators requires every health insurance plan in North Dakota to have protection for North Dakotans. The insurance department is asking that consumers — before paying any bills to an air ambulance company — reach out to their insurance company or to the Insurance Department at (800)-247-0560.

“Historically, these flights have often been followed by life-altering bills regardless of whether the patient has health insurance,” Godfread said in a press release. “Many consumers we’ve heard from did not have the option or ability to choose their provider because of the circumstances. Instead, a third party chose their air ambulance service and now the consumer, through no fault of their own, is left facing bankruptcy. The department has worked tirelessly during the last two legislative sessions to protect our consumers from this outrageous practice. This hard work has finally come to fruition through our ability to regulate how insurance companies pay claims.”

The department also said air ambulances that transport from hospital to hospital are also common, and state law requires hospitals to notify patients of their contracted air ambulance services in all non-emergency situations. A document about in-network air ambulance providers that work with North Dakota’s three health insurance companies is available at

— Chris Aarhus, NDFU