Join – Jacobus Lions Club Foundation

What Your EMS Subscription Includes

An EMS subscription helps protect you from a portion of ambulance-related out-of-pocket costs while supporting your local EMS agency.

Emergency Treatment and Transport

Your subscription includes unlimited emergency treatment and transport, upon availability, to a Pennsylvania Department of Health approved closest emergency room, which may include York Hospital, UPMC Memorial, or Hanover Hospital.

Reduced Out-of-Pocket Expenses

Subscribers are exempt from 50% of out-of-pocket ambulance expenses that may not be covered by their insurance carrier.

Subscribers are still responsible for any co-payment or co-insurance required by their insurance carrier.

Surrounding EMS Agency Coverage

Membership subscribers may also be covered by surrounding EMS agencies at those agencies’ discretion.

Important Subscription Information

EMS subscriptions do not cover Patient Refusal Fees.

This is not an insurance policy. Non-subscribers and/or uninsured patients are responsible for payment in full.

Current EMS Subscription Rates

Senior

$60

Per senior over 65

Individual

$80

Per individual under 65

Household

$160

Per household

Membership term: January 1 – December 31

Additional donations are greatly appreciated and help support equipment, supplies, uniforms, and the continued operation of your local EMS service.

Step 1

Join the Ambulance Club

Choose a plan, choose renewal preference, and tell us who the coverage is for.

Individual Coverage for one person. $80 Household Coverage for a household. $160 Senior Senior coverage with eligibility confirmation. $60

Step 2

Choose renewal preference

Choose one-year manual renewal or optional auto-renew each January 1.

One year only Coverage for the current year. Renew manually next year. Renew automatically Automatically renews each January 1 unless cancelled.

This plan is for one coverage year. The member renews manually next year.

Step 3

Who is this coverage for?

Separate payer information from covered-member information when coverage is purchased for someone else.

Myself / my household Use the purchaser’s information as the starting point for coverage details. Someone else Collect separate covered-member and service-address information.

Step 4

Covered member information

This information should drive the member record, cards, and exports.

Covered first name

Covered last name

Covered address line 1

Covered address line 2 (optional)

City

State

ZIP code

Covered phone (optional)

Additional covered household members

Add up to 3 more covered household members below. Do not include the primary covered member listed above.

Additional member 1

Additional member 2

Additional member 3

I confirm that the covered member meets the Senior plan eligibility requirement.

Member note (optional)