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TotalCare
Public Information & Marketing

Every September, The City of Oklahoma City gives you the opportunity to change your participation in EMSA’s TotalCare program.

The opt-in/opt-out period is September 1-30.

TotalCare provides you and permanent members of your household with emergency medical transport through EMSA, with no out of pocket expenses.  Your membership covers expenses not paid for by your third party insurance.  The program is just $3.65 per month and can be included on your utility bill.  More than 180,000 Oklahoma City households participate in EMSA’s TotalCare program.

With the charge for a single emergency ambulance ride now over $1,300, it is easy to see that TotalCare is the smart choice for you and your family.

Cost

Cost is $3.65 per month, which will be billed on your water and trash utility bill. The first billing cycle begins in October, which is the first day coverage begins for newparticipants. Coverage for all newparticipants begins October 1.

For renters:

Apartment owners are required to notify tenants if they choose to opt out of the TotalCare program. If your apartment has chosen not to participate, you can call (405) 396-2888 and sign up.

What is not covered

TotalCare does not cover non-emergency transports to and from doctors’ offices, dentists’ offices, physical therapy centers, pharmacies and other facilities. A non-emergency transport is an ambulance transfer that does not end at a hospital emergency room. Non-emergency transports are fully covered only if insurance or other third-party coverage covers a portion of the claim, and if a physician certification statement (establishing medical need for the ambulance transport) is provided. When no insurance or third-party coverage is available, TotalCare members pay a reduced fee (40 percent off the standard non-emergency rate) for medically necessary non-emergency transports.

Collection

Approximately 10-15 days after your transport, you should receive a letter from EMSA requesting the name of your insurance provider. Your insurance provider is responsible for payment of ambulance services. Your TotalCare membership covers all out of pocket expenses associated with your ride – expenses not covered by your insurance policy. Once you receive the letter, you will have 60 days to provide EMSA with insurance information pertaining to yourself or anyone living in your household covered by EMSA. Failure to provide the information nullifies your membership.

Oklahoma City Limits

EMSA will collect payment from participating resident’s insurance, Medicaid or Medicare. To receive TotalCare benefits, you must provide EMSA with your insurance/third-party payer information and furnish any information requested by your insurance company after a transport. Out of pocket expense will be covered by your TotalCare membership.
Oklahoma City Limits

It is not uncommon in Oklahoma City for residents to be confused about what city they actually live in. Many homeowners with a Yukon, Edmond or Moore address live in Oklahoma City and don't know it.

One of the factors that confuse this issue is the fact that the U.S. Postal service is not concerned about where you actually live. Your address is determined by which post office delivers your mail. The assignment of school districts adds to the mix-up as well.

This map can help you determine if you are a resident of Oklahoma City:

This information is also important to know when it comes to Oklahoma City elections.

History

Oklahoma City’s TotalCare program was launched on October 1, 2009.  Households were automatically enrolled in the ambulance program and residents had the option of opting out during the month of September.

The program was created because the cost to provide reliable service was growing faster than the City’s general fund budget could afford.  

Without TotalCare, the difference between the cost of operating an efficient and available ambulance services and the revenue brought in by EMSA would be millions of dollars.  As the population ages, these costs will continue to rise.
                       
Costs exceed EMSA’s revenue for several reasons:

1. Medicare and Medicaid have capped reimbursement for ambulance services at levels below the cost of providing the service. In 2009 these patients represent over half of all EMSA transports.

2. Approximately 21% of those transported to hospitals in 2009 weren’t insured or were unable to pay.

This program gives residents a benefit while also addressing the growing costs.