Cranberry Township EMS Ambulance Service Subscription Program

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1 Did you know the average ambulance ride costs $850? Cranberry EMS Subscriptions are just $60 for your entire household for one year. Through the Ambulance Service Subscription Program, you can save hundreds of dollars in medical bills should you or a family member ever need an ambulance. Your paid subscription will offset the costs of co-payments and deductibles that your insurance company may require you to pay. It will also allow Cranberry Township EMS to continue serving the community, ensuring that we have the staff, vehicles and equipment to provide you with around-the-clock care, 365 days a year. Subscription Types You have the option of subscribing three different ways Family Membership ($60) Covers all permanent residents of your home. Individual Membership ($45) Covers only the individual listed on the subscription card. Senior Citizen Membership ($40) Covers an individual 62 years of age or older, as well as all other permanent residents of that household. Thank you for your continued generosity and support., Route 19, Suite 51, Cranberry Twp, PA Find us on Facebook and The official registration and financial information of Cranberry Township EMS may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania, Registration does not imply endorsement. Ambulance Service Subscription Program Protect yourself and your family, today! We proudly serve the people of Cranberry Township, Seven Fields Borough and parts of New Sewickley Township.

2 The Benefits of Your Subscription Personal and community advantages Not only will you save hundreds of dollars in unwanted ambulance charges, you will also show your support for your local EMS. We are not affiliated with the fire department and therefore we do not receive any direct tax subsidies from the municipalities that we serve. We depend on your generous donations so that you can depend on our services. With your paid subscription, we will be able to continue supporting the community and further protecting you and your family. Coverage beyond your community maintains reciprocal agreements with all of our immediate surrounding EMS services and 17 other organizations who are members of the Northeast Ambulance Alliance. This means that if you become ill or injured in any of these communities and require medically necessary emergency service, your Cranberry Township EMS subscription will be honored. No unnecessary insurance costs Your subscription ensures that should a medically necessary emergency ambulance service be required, you will not incur any unnecessary insurance bills. Most insurance companies do not pay 100% of ambulance bills. If your overage includes a deductible or a co-payment, you could be left with a large balance to pay out-of-pocket. If you choose not to subscribe, you would be responsible for the full payment, which could exceed more than $850 per trip. While covers your emergency situations, non-emergent care is not covered by your subscription. Alternative modes of non-emergency transportation, such as wheelchair van or invalid coach transports Certain non-emergency ambulance transports, which may be denied or deemed outside the limits of your insurance coverage Transports which do not meet medically necessity criteria Any charges related to excessive mileage or other non-covered charges for transports, which are based solely on patient and/or physician preference No ambulance cost for emergencies No matter how frequently you may need our services, you will not pay any out of pocket expenses for emergency ambulance services beyond your one-year subscription fee. Should you need an ambulance, will submit a bill to your insurance company. Insurance payments are then applied to your balance, and once your insurance benefits are exhausted, we will write off any remaining balance. Additional questions? For more information on the subscription program, please contact or visit us online at

3 The Benefits of Your Subscription Did you know the average ambulance ride costs $850? Personal and community advantages Not only will you save hundreds of dollars in unwanted ambulance charges, you will also show your support for your local EMS. We are not affiliated with the fire department and therefore we do not receive any direct tax subsidies from the municipalities that we serve. We depend on your generous donations so that you can depend on our services. With your paid subscription, we will be able to continue supporting the community and further protecting you and your family. Cranberry EMS Subscriptions are just $60 for your entire household for one year. Through the Ambulance Service Subscription Program, you can save hundreds of dollars in medical bills should you or a family member ever need an ambulance. Your paid subscription will offset the costs of co-payments and deductibles that your insurance company may require you to pay. It will also allow Cranberry Township EMS to continue serving the community, ensuring that we have the staff, vehicles and equipment to provide you with around-the-clock care, 365 days a year. Subscription Types You have the option of subscribing three different ways. 1 Family Membership ($60) Covers all permanent residents of your home. Coverage beyond your community maintains reciprocal agreements with all of our immediate surrounding EMS services and 17 other organizations who are 2 3 Individual Membership ($45) Covers only the individual listed on the subscription card. Senior Citizen Membership ($40) Covers an individual 62 years of age or older, as well as all other permanent residents of that household.

4 2015 Ambulance Service Subscription Protect yourself and your family, today! Three easy ways to subscribe: 1. Check 2. Credit Card 3. Online Subscribe now by completing the back of this form, or online at Please make necessary corrections to name and address. Mr. John Smith 123 FPO Street Cranberry Township, PA Ambulance Service Subscription Card For emergency calls, dial For other inquiries with, dial Expires December 31, 2015

5 Your subscription covers medically necessary emergency ambulance services (excluding wheelchair van transportation) until December 31, All services are subject to terms and conditions, available upon request. reserves the right to all available third party claims. Thank you for your support! Choose your subscription rate: Family Membership ($60) Individual Membership ($45) Senior Citizen Membership ($40) Optional Donation Amount Check your municipality: Cranberry Township Seven Fields Borough New Sewickley Township Choose payment option: Check (payable to Craberry Township EMS) Card Number: Name as it appears on card: Credit Card (fill out below) Expiration Date: I authorize to charge the total amount of the subscription/donation payment to my credit card. I will be responsible for payment of all applicable charges. Please print all names of family members residing in your home. Signature: Date: