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Air St. Luke's Membership Request

Air St Lukes | Membership

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New member and lapsed member enrollment and benefits take effect 3 days (72 hours) after receipt of a completed enrollment form with payment.

By clicking the "Make Payment" button, I indicate that I have read and agree with the benefits, terms and conditions of the Air St. Luke's Membership Agreement.

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Air St. Luke's Membership Agreement

Membership in Air St. Luke’s is a way of showing your support for the specialized critical care transport services provided by St. Luke’s Medical Center. Initial annual membership is $60 per family per year. In recognition of your support, Air St. Luke’s will accept payment from your primary insurance as payment in full for any medically necessary Air St. Luke’s air or ground transport. This benefit also extends to other medically necessary air ambulance services provided by members of the Association of Air Medical Membership Programs (AAMMP).

Air St. Luke’s Membership Agreement

 By becoming a member, I understand that:

  1. Air St. Luke’s Membership is not an insurance or investment program and has no guaranteed benefit. The purpose of membership is to support Air St. Luke’s.
  2. The membership benefits are for me, my spouse or domestic partner, and any unmarried dependent children, claimed on my income tax return and listed on the enrollment form. Dependent children must be younger than 19, or younger than 24 and full-timea student claimed on my income tax return. Non-qualifying dependents will need their own membership.
  3. The benefits of Air St. Luke’s Membership covers air ambulance and ground ambulance charges for medically necessary services provided by Air St. Luke’s or partnering affiliates only. Local 911 emergency ground ambulance response is not included.
  4. Medical necessity can only be determined by a physician or EMS personnel.
  5. Reciprocity among partnering member programs is subject to the reciprocating program’s rules.
  6. Both ground and air emergency medical transports are based on medical need, not membership status. Not every illness or injury requires air transport. Patients will be transported to the closest, medically appropriate facility as determined by a physician or emergency personnel.
  7. New member enrollment and benefits take effect three days (72 hours) after receipt of completed enrollment with payment and continues for one (1) year thereafter, unless purchasing a lifetime membership or a future date is noted.
  8. Per government regulations, individuals covered by Medicaid are not eligible and should not apply for membership.
  9. I transfer directly to St. Luke’s my rights to insurance payments due to me for air or ground ambulance transport. Such payments shall not exceed Air St. Luke’s regular charges. I will cooperate with Air St. Luke’s in obtaining any insurance payments that are available to me. Failure to provide necessary insurance information or failure to cooperate in obtaining insurance payments, may void any Air St. Luke’s Membership benefits.
  10. The Air St. Luke’s Membership benefit is secondary to all other insurance payments.
  11. Conditions that are the result of being engaged in an illegal occupation, commission or attempted commission of an assault, or other illegal act are excluded from receiving membership benefits.
  12. While every reasonable effort will be made, service cannot always be guaranteed due to weather conditions or commitment to another transport.
  13. Memberships are non-refundable, non-transferable, and may not be assigned to other individuals.
  14. Proof of membership is not required at the time of transport.

Questions: Call an Air St. Luke's representative at 1-800-822-1616 or (208) 706-1000.
Questions: Call an Air St. Luke's representative at 1-800-822-1616 or (208) 706-1000.