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Corry Ambulance Service is a joint venture of Corry Memorial Hospital and EmergyCare Inc

CORRY AMBULANCE

612 WEST SMITH STREET

CORRY, PA 16407

 

 

 

 

 

 

 

 

 

Signing up is EASY!  First be sure to read the Service Agreement below, then simply do one of the following...

-CLICK HERE to open a printable version of the application form.  Print the form from your browser, fill it out and mail it with the appropriate payment to:

 

 

 

You can also sign up online by clicking the button below

Subscribe Online

-Call (814)664-9553 for more information!

 

 

 

 

 

 

$37 Individual    $42 Senior Couple    $47 Family

 

-Unlimited Emergency Ambulance Response

-Emergency Paramedic Response (see terms of agreement)

-Regional Coverage where CASI has a reciprocal agreement with other services.

-Covers your Co-pay and Deductible

-2 FREE one-way vouchers per member household for wheelchair or medical taxi

-FREE "Friends and Family" CPR class or $10 off Healthcare Provider Course or Heart-Saver CPR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SERVICE AGREEMENT

-Membership benefits include unlimited emergency ambulance coverage when provided by Corry Ambulance Service, inc. through November 9, 2007

-Membership benefits also includes non-emergency stretcher ambulance transportation within a 150-mile radius of Corry or divisional headquarters, if it is medically necessary and a reimbursable service as defined by your insurance provider and/or the Centers for Medicare and Medicaid Services (CMS).

-Corry Ambulance Services, inc. paramedic response service, if it is a reimbursable service as defined by your insurance provider.

-For members that do not have available insurance coverage for ambulance/paramedic service, any non-emergency ambulance service will be provided in accordance with Medicare coverage requirements.  Any service provided outside these coverage requirements will be the financial responsibility of the member (e.g., long distance transport to a hospital other than "closest appropriate hospital" under Medicare rules).

-Corry Ambulance Services, inc. will bill all insurances and accept available insurance reimbursement as "payment in full".

-Corry Ambulance Services, inc. ambulance membership IS NOT a health insurance plan.

-Medical necessity certification is required for all non-emergent (scheduled) ambulance service. "Medical necessity" is defined as being bed-confined or otherwise having a medical or physical condition that prevents transportation by any means other than an ambulance.  Failure to provide certification of medial necessity by a physician or other approved health care professional that you need an ambulance for non-emergency transportation will result in patient responsibility for full payment of services rendered.

-Corry Ambulance services, inc. is non-transferable, AND non-refundable

-Membership coverage takes effect immediately upon payment of the membership fee.

-For federal income tax purposes, the membership fee is not deductible as a charitable contribution, but in come situations may be an eligible deduction if you itemized medical expenses.

-Family membership includes everyone who resides in the member household AND anyone who is visition a member household.

-Emergency ambulance service, in some areas, is provided separately by volunteer fire departments.  The volunteer fire department ambulance charges may not be covered under this membership.

-MEMBERSHIP INFORMATION