Membership Registration

Download a Brochure

Download a Brochure

MEMBERSHIP AGREEMENT

Emergency Airlift will provide emergent medical services to its members under the following terms and conditions:

MEMBERS

Members shall include the first person listed in the membership information below, together with member's spouse and eligible unmarried family members who live at the same address and are listed on your income tax as legal dependents. Membership does not include roomers or boarders.

SERVICE

Enrollment into the Emergency Airlift membership program entitles its members to services consisting of emergency, doctor approved, closest hospital, medically necessary air transportation by Emergency Airlift. The air transportation services will include attendant care by state-certified trained technicians. Ground transportation and services provided by any health care provider other than Emergency Airlift will not be covered. All services must originate or terminate within the boundaries served by Emergency Airlift.

Your membership entitles you to one air ambulance flight per year (the twelve month period beginning with the effective date of your membership and the twelve months of any subsequent renewal of your membership.)

Availability of service cannot always be guaranteed due to weather conditions, geographic restraints or commitment to another patient transport.

MEMBERSHIP FEE

Annual membership fee is $35.00 (NOTE: This is a limited offer and fees are subject to change).
Emergency Airlift agrees to provide the services prescribed herein to the enrolled member, member's spouse and eligible unmarried family members who live at the same address and are listed on your income tax as legal dependents. Membership does not include roomers or boarders.

PROTECTION IN EXCESS OF INSURANCE COVERAGE

The protection provided by this membership is in excess of existing insurance coverage, or any other applicable benefits to which a member is entitled at the time of claim. Emergency Airlift agrees to collect directly from any agency or insurance company whatever benefits are available.

Emergency Airlift reserves the right to directly bill your benefits provider for Emergency Airlift services. Emergency Airlift will accept payment from insurance carriers as payment in full.

All fees and charges for services by Emergency Airlift pursuant to this agreement and in excess of the insurance and other benefits available to the member are automatically covered by the membership without additional charge. Any such proceeds received directly by the member from an insurer or other entity providing applicable benefits shall be held in trust by the member for the benefit of Emergency Airlift and shall be tendered to Emergency Airlift immediately upon receipt thereof by the member.

Membership is not solicited from persons who receive welfare medical benefits and such membership constitutes a voluntary contribution only.

SERVICE AREA

Emergency Airlift currently services only hospitals based in Oregon, Washington and Northern California.

ENTIRE CONTRACT; CONTRACT CHANGES

This membership form, including endorsement and enrollment form, constitutes the entire agreement between the parties. No change shall be valid until approved by an executive officer of Emergency Airlift and unless such approval be endorsed hereon or attached hereto. No agent has authority to change this policy or waive any of its provisions.

In the event Emergency Airlift shall be unable to perform or complete any flight due to any cause beyond its control, including but not limited to weather conditions, geographic restraints or commitment to another patient transport, Emergency Airlift shall not be responsible for any damages, costs or replacement services procured by Member.

TRANSPORT BY OTHER COMPANY

Members will not receive benefits if transported by an air ambulance company other than Emergency Airlift.

EFFECTIVE DATE OF AGREEMENT

Membership is effective 30 days after receipt of the completed agreement and fee by Emergency Airlift, and expires 12 months from that date. Emergency Airlift is under no obligation to renew your membership. Emergency Airlift reserves the right to cancel your membership at any time giving 30 days written notice of cancellation. In the event of cancellation, Emergency Airlift will refund membership fees for any year membership that is cancelled. Continued membership is dependent upon the annual renewal. Membership purchases are non-refundable.

MEMBERSHIP CARDS

You, your spouse, and the legal dependents you list on this form will receive a membership card by mail after your membership has been processed. It takes approximately 30 days to process your membership.

QUESTIONS

If you have any questions please call our corporate offices at (541) 756-6802. Monday through Friday between 8:00am and 5:00pm.

Client Information

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