first flight advantage plan application
$50 • 1 Year Contract Term
- Fees are per household, payable at time of application and terminated on the month and date of postmark.
- Please fill out the following information and submit form, once form is submitted you will be prompted to pay with paypal.
- Terms & Conditions apply
Membership Terms & Conditions
First Flight is a membership program which covers the uninsured or otherwise uncovered portion of the flight charges that may be incurred by members who are transported on a First Flight medically configured aircraft as set forth herein. Membership is valid for one (1) year beginning five (5) days after your completed application and nonrefundable payment have been received and processed by the First Flight membership office. These Terms and Conditions also apply to renewing memberships, provided that payment of the annual membership fee is received within thirty (30) days of the renewal date.
Members are charged an annual membership fee payable yearly in advance. The annual membership fee charged by First Flight is based on certain factors, including whether you have healthcare insurance coverage.
A Member who receives a medically necessary transport through the First Flight Advantage Plan is relieved from paying any charges related to the medical transport other than amounts paid or reimbursed to the Member by any available healthcare insurance, a third party payor, or a third party who may be legally responsible for the charges. In other words, First Flight Advantage accepts what your insurance or other third-party source of payment pays as “payment-in-full,” relieving you of any other charges for the air medical transport.
First Flight will bill your healthcare insurer or other third-party payor (for example, Medicare), or seek recovery from any legally liable third party (for example, a car accident which causes you injury as a result of someone else’s fault or negligence) for the air medical transport. Should you receive payment directly from your healthcare insurer, other third-party payor, or from a legally liable third party for all or any portion of the charges for the air medical transport, you agree to promptly remit such payment to First Flight. If any third party or his/her insurer who is legally liable pays for the air transport charges either through settlement of a claim or a judgment from a lawsuit, you agree to promptly remit the amount received by you for air transport charges included in such settlement or judgment.
First Flight Advantage Members are responsible for and agree to pay for any charges that are not covered by the First Flight Advantage Program, including but not limited to air transport pick-ups outside of the First Flight service area or any ground ambulance transportation services that members may incur in connection with any First Flight air medical transport.
Eligibility & Availability
*Medicaid participants are not eligible for membership in the First Flight Advantage Plan. *
Please note that a First Flight aircraft may not be available at the time a flight request is made due to inclement weather, the First Flight aircraft being in service at the time of the request, the First Flight aircraft undergoing maintenance or repairs, weight limitations of the First Flight aircraft, or other reasons that make the First Flight aircraft unavailable to respond to a request. Further, medical or dispatch personnel may call another air ambulance provider in which event your First Flight Advantage membership will not cover the medical transport.
Passenger weights and other operating restrictions may limit our ability to transport a member.
First Flight, in consultation with other healthcare providers or dispatch agencies, reserves the right to determine whether air medical transport is medically necessary, safe, and appropriate under the circumstances.
Membership in the First Flight Advantage Plan is not an insurance product.
Notifying First Flight Advantage Membership Department of Transport
You should inform the healthcare provider, dispatcher, or emergency personnel of your First Flight Advantage membership at the time an air medical transport is requested, as these personnel will not be aware of your First Flight Advantage Membership. In addition, it is the responsibility of each Member to contact us if a registered and eligible household dependent has been flown by First Flight. Please call our Membership Department at: 972-837-3340, Monday-Friday, 0800 to 1700 Hours CST.
Termination and Renewal of Coverage
First Flight Advantage may terminate your membership for failure to comply with the Terms and Conditions of the First Flight Advantage membership program. First Flight Advantage reserves the right to discontinue its First Flight Advantage Program at any time upon notice to Members. In such event, First Flight shall return a pro rata portion of the membership fee. First Flight Advantage also reserves the right to unilaterally modify the Terms and Conditions, including but not limited to the membership fee to be charged to Members who join or renew their membership after the effective date of such change.
It is your responsibility to renew your membership prior to the expiration of the one-year term. A completed renewal application and nonrefundable payment must be received within thirty (30) days of the renewal date. If you do not renew your membership, your membership and coverage thereunder will automatically terminate at the end of the one-year term. Renewal contracts may include changes in coverage.
You acknowledge that all information included in the completed application is correct to the best of your knowledge, including all health insurance information. If your healthcare insurance is no longer in effect at the time air medical services are rendered, your First Flight Advantage membership will not cover your air medical transport charges. Any changes in your healthcare insurance information, including the cancellation of healthcare insurance coverage, must be reported to the First Flight Advantage membership office within five (5) business days of such change or cancellation.
By approving and submitting your application for First Flight Advantage membership, you agree to all of the Terms and Conditions set forth herein.