Advance Life Support,

Rescue and Transport

Safety
• Advanced avionics
• Night vision goggles
• Highly experienced pilots
• Modern aircraft

Capability
• Nurse/Medic Teams
• Rapid response times
• Rough terrain access

Availability
• On duty 24/7/365
• Back up aircraft
• Membership plan

Subscription Membership Terms and Conditions

1) Purpose: This subscription membership program is designed to
allow Classic Lifeguard Air Ambulance to provide members with
a reliable and available air ambulance service in exchange for
advanced financial support from you. Classic Lifeguard will not
charge any subscribing member for co-payment and deductible
amounts that are otherwise billable on a pre-transport basis, as
allowed by law. Your participation in this program will completely
discharge all financial liability incurred by the use of Classic
Lifeguard’s aircraft but is designed that part of your financial liability
resulting from co-payment and deductible expenses. Please note that this subscription membership is not designed to be an insurance contract of any type, and does not guarantee ambulance services will be provided by Classic Lifeguard.

2) Membership: “Subscribing members” (all persons listed in your
application materials) are entitled to the use of Classic Lifeguard
emergency transport aircraft, when medically necessary, and
based upon availability of resources, without being responsible for
co-payment and deductible amounts that are typically charged to
cover amounts that are not paid by insurance. This waiver of copayment and deductible obligation only applies to persons listed
on the membership application. This subscription program does not
apply to persons receiving medical benefits. Membership benefits
take effect one day after receipt by Classic Lifeguard’s business
office of a completed application and associated payment of the
annual membership fee.

3) Payment: Subscribing Members are responsible for initial
payment of the annual membership fee as outlined on these
membership application materials. The member will not be responsible for any other payments for air ambulance services where insurance makes primary payment and you would not otherwise be responsible for co-payment and deductible payment. Classic Lifeguard will submit bills directly to your insurance payment of air ambulance services that are provided. If a subscribing member receives payment for an air ambulance service directly from an insurance company, such payment must be turned over to Classic Lifeguard. It is improper and illegal to keep reimbursement received for air ambulance provided by Classic Lifeguard. Subscribing members are expected to cooperate with Classic Lifeguard in all collection efforts, and recognize that Classic Lifeguard may initiate legal action against a patient/subscriber for failure to pay Classic Lifeguard for amounts he or she may be responsible for.

4) Emergency Transportation: I understand that air ambulance
transportation covered in this membership is limited to emergency
transport to the closest appropriate medical facility that is deemed
“medically necessary” by the applicable insurance plan in which I
am enrolled.

5) Non-Emergency Services: I understand that membership
includes access to pre-scheduled non-emergency air ambulance
transport that is medically necessary (as determined by Classic
Lifeguard and/or applicable insurance). Non-emergency service
is subject to availability of staff and equipment, and emergency
transports always have priority. 24-hour advanced notice and
physician authorization may be required for non emergency
services. This is an additional service that is available, but
not guaranteed based upon subscription membership. Preauthorization and/or physical certification may be required to
demonstrate that air ambulance transport is warranted.

6) Service Area: Classic Lifeguard will pick up patients for transport
in Arizona, Idaho, Montana, New Mexico, Utah, Colorado and
Wyoming. Ground transportation may need to be provided by
the patient/primary care provider to an airport that meets the
requirements to support Classic Lifeguard’s aircraft. For additional rules and regulations that my apply, please log onto www.classiclifeguard.com