I’ve been billed $97k for rushing my baby 86 miles for care when he couldn’t breathe – but insurance refuses all of it

A MOTHER who attempted to save her baby's life has revealed that hospital transportation alone cost her family almost $100,000 which the insurance refused to cover.

Sara England noticed her infant son, Amari Vaca, was struggling to breathe and rushed him to the hospital, but her life-saving efforts would have devastating financial consequences.

When baby Amari arrived at Natividad Medical Center in Salinas, California, England told KFF Health News that doctors immediately noticed that the three-month-old was struggling to breathe and needed specialized care.

Her son was said to have been declining rapidly forcing doctors to put a tube down the infant's throat before he could transition to using a ventilator.

Once he was stable, doctors told England that they had a bed ready for her child at California-San Francisco Medical Center, and she could get there with EMTs by taking a small plane.

England's son, who had open heart surgery two months prior, was diagnosed with respiratory syncytial virus (RSV) and had to spend three weeks in the hospital.

However, once she was home she realized her insurance provider, Cigna, refused to cover her flight, leaving her with a $97,599 bill.

“I thought there must have been a mistake,” England said.

“There’s no way we can pay this. Is this a real thing?”

Cigna did not consider Amari's air ride a medical necessity, according to the coverage denial letter.

The insurer claims that the baby could have used a ground ambulance to cover the 86 miles between the two hospitals.

The No Suprise Act is supposed to allow the insurer and the air-ambulance provider to determine fair payment according to the law.

However, this can only be done if the insurer believes it was a necessary step to save the child's life.

“What they’re basically saying is that the parents should have opted against the advice of the physician,” Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation explained.

“That’s insane. I know ‘medical necessity’ is this nebulous term, but it seems like it’s becoming a catch-all for turning down patients.”

Patricia Kelmar, a health policy expert and senior director with the U.S. Public Interest Research Group believes that the hospital should have offered in-network alternatives.

“The hospitals who live and breathe and work in our communities should be considering the individuals who come to them every day,” Kelmar said.

“I understand in emergency situations you generally have a limited amount of time, but, in most situations, you should be familiar with the plans so you can work within the confines of the patient’s health insurance.”

But England blames the stress of the situation solely on Cigna.

“As parents, we did not make any of the decisions other than to say, yes, we’ll do that,” she said. “I don’t know how else it could have gone.”

The struggling mother attempted to appeal the bill twice and was denied.

On her third attempt, England asked staff members at Natividad Medical Center to write an appeal letter on his behalf, but they claimed it was against policy.

However, a spokesperson for Cigna reached out to offer help with her final appeal.

“It is disappointing that CALSTAR/REACH is attempting to collect this egregious balance from the patient’s family,” the Cigna spokesperson, Justine Sessions, said in an email, referring to the air-ambulance provider.

“We are working diligently to try to resolve this for the family.”

The U.S. Sun has reached out to Cigna for comment.