CG-ANC-04 Ambulance Services: Air and Water

This policy addresses coverage for air and water ambulance transport services. Coverage is medically necessary only when all criteria are met: the ambulance is properly equipped; the patient’s condition makes any other transport medically contraindicated; and transport is to the nearest appropriate facility either from an emergency scene with a life‑threatening condition (including when deemed life‑threatening by first responders) or between facilities when the originating facility lacks required services. Not covered: transfers that do not meet these criteria, transfers for convenience, situations where ground transport is available without jeopardizing life or health, and transport to non‑acute facilities if criteria are not met.

"The use of air and water ambulance services is consideredmedically necessarywhenallthe following criteria are met:"

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