By submitting an online Membership Application to Medstar Ambulance of Mendocino County Inc. ("Medstar") dba Ukiah Ambulance, on behalf of yourself and the residents of your household or affiliated group members listed on the application or added during the Term of Coverage, you are agreeing to these terms and conditions.
Out-of-county transports, inter-facility transfers (e.g. hospital to hospital), return trips (e.g. hospital to home or skilled nursing facility), elective transports (e.g. doctor or dialysis appointments) and transports by wheelchair van are excluded from the Membership Program. Medstar Membership only applies to treatment/ground transport by Medstar at/from the scene of an emergency within the Medstar Service Area. Medstar reserves the right to cancel a Membership at any time.
TERM OF COVERAGE: Coverage will begin upon receipt and approval by Medstar of completed application and payment and will expire 364 days from that date.
PERSONS COVERED: Membership covers you (the primary member or group administrator) and other household or group members (collectively "Members") listed on your application, so long as household members remain full-time residents of the same household as specified by physical address. New household or group members may be added, household or group members may be deleted, or the physical address of the household, business or organization may be changed online at medstarmendocino.org, or by written notice to Medstar to become effective the day following receipt of such notice. References to "you" and similar references herein shall be construed as including all Members. Medi-Cal/Medicaid beneficiaries (e.g. those covered by Partnership HealthPlan of Northern California) are not eligible for membership because Medstar accepts Medi-Cal/Medicaid as full payment for services rendered.
ASSIGNMENT OF BENEFITS: You hereby assign to Medstar all rights and benefits that you have under any and all medical, health, supplemental, worker's compensation, liability, auto or homeowner's insurance policies or plans, or from other third party payers or sources which provide coverage or would otherwise pay for ambulance services covered by this Membership. Such payment sources are collectively referred to herein as "insurance." You authorize payment of all insurance benefits or payments for ground ambulance services covered by this Membership to Medstar. You understand that Medstar will, whenever it deems is feasible, file claims for and directly collect the benefits payable from insurance, up to the amount payable from insurance, up to the amount of Medstar's charges for its services. When requested by Medstar, you agree to complete any forms and take any other reasonable action that may be necessary to collect such amounts. If you or anyone on your behalf receives any insurance or third-party payments for ground ambulance services provided by Medstar, you will promptly turn over those payments to Medstar.
BENEFITS: You understand that you are responsible for payment for all ground ambulance services provided to you by Medstar. However, this Membership will discharge and relieve you of your responsibility and of your financial liability that is not covered by your insurance for emergency transportation by Medstar. You agree to pay Medstar for any services it provides that are not covered by this Membership. Membership does not cover services rendered by another provider.
SERVICE AREA: The Service Area covers boundaries set forth by the County of Mendocino. At present, this includes the cities of Ukiah and Willits, towns of Brooktrails, Calpella, Hopland, Potter Valley, Redwood Valley, Talmage and other unincorporated areas along the US 101 corridor in south-inland Mendocino County. A map approximating the Service Area is available at medstarmendocino.org. Medstar may be dispatched out of the Service Area to emergency calls in other locations within Mendocino County. This often occurs because the primary ambulance provider for that area has requested an advanced level of care, or because the primary provider is unavailable. Such locations will be considered part of the Service Area exclusively for the emergency call to which Medstar is dispatched.
HOW MEDSTAR IS DISPATCHED: Every county operates under its own guidelines for emergency ambulance service. An ambulance will be dispatched to an emergency only in accordance with county protocol. Medstar does not control how Mendocino County dispatches emergency ambulance services. If you are able, you may request Medstar, but there is no guarantee that Medstar will be the provider that is activated. Another ambulance service may be dispatched even if you are a Medstar member, depending upon availability and proximity.
BEFORE YOU PURCHASE: If you are currently enrolled in a health maintenance organization (HMO) or other health insurance, the benefits provided by the Medstar Membership Program may duplicate the benefits provided by your HMO or other health insurance. If you have a question regarding whether your HMO or other health insurance offers benefits for ambulances services, you should contact that other company directly.
WARNING: The Medstar Membership Program is not an insurance program. It will not compensate or reimburse another ambulance company that provides emergency transportation to you or your family. This may occur when the 911 Emergency System has independently determined that another company could provide more expeditious service or is next in the rotation to receive a call. This might also occur when Medstar is unable to perform within a medically appropriate timeframe due to a mechanical or maintenance problem or being on another call.