Membership coverage begins 72 hours after the acceptance of your application form with payment. Your coverage continues until June 30 of the current enrollment period.

Open enrollment is from May 1^st – June 30^th every year. There is no deadline to enroll, but open enrollment offers the best value for your coverage period.

LifeGuard membership includes the enrolled member, plus all persons living in the same household and claimed as dependents on your tax forms.

LifeGuard goes wherever you go in Oregon. Membership coverage extends throughout all of Oregon’s almost 96,000 square miles, for all of your household members.*

1) Prehospital, emergency medical treatment and transport.

2) Medically necessary ambulance transport between medical facilities, preauthorized by a physician.

3) Automatic insurance billing service.

4) Up to two response fees waived.

Please call (541) 265-3175 for more information membership benefits, how to enroll or to renew your existing membership benefits.

LifeGuard membership saves lives, saves money, and offers cost protection and convenience. Moreover, membership provides the invaluable benefit of the peace of mind that comes with the security in knowing that you and those you love are safe. In the seconds that count, you can count on LifeGuard.

Statement of Understanding:

Ground Ambulance Membership Agreement: Our membership program assures you of the finest emergency ambulance care and transport and protects you from any “out-of-pocket” costs. Your agreement for services is as follows:

1. Fully covered services:

• Medically necessary Emergency Ambulance Transports
• Transfers to another facility for a higher level of care (As requested by a physician)

2. Additional Services:

• Up to two treat & release fees waived per year.

3. Services that are not covered:

• Wheelchair transportation or transfer of patient for family convenience.
• The member is financially responsible for payment of medical services and/or ambulance transportation which is deemed not medically necessary and is denied payment by the member’s insurance/health plan provider.

4. Member eligibility:

• LifeGuard membership includes the enrolled member, plus all persons living in the same household and claimed as dependents on your tax forms.

5. Duration: Membership coverage begins after acceptance of a properly completed application form with payment, and extends to June 30 of the following year.

6. LifeGuard Membership benefits are extended to the primary member, his/her spouse or domestic partner and their dependents claimed on their income tax return. Elderly or disabled family members living in the same household are also covered.

7. The first person listed on the application form is designated as the “Primary Member.” Only those persons who meet the membership eligibility requirements AND are listed in the membership record at the time services are rendered are eligible for benefits. Per government regulations, individuals covered by Medicaid are not eligible for membership and should not apply.

8. LifeGuard Memberships are not an insurance policy but secondary to insurance carriers. All available insurances will be billed first. We will accept payment from insurance carriers as payment in full.

9. Ground emergent 9-1-1 and inter-facility transports are based on medical need, not membership status. Patients are transported to the closest medically appropriate facility as requested by the physician or EMS system. Non-emergent transports are not covered by this agreement.

10. New and lapsed Membership benefits take effect 72 hours after receipt of a completed enrollment with payment.

11. Renewal payments must be received prior to the expiration date to avoid a lapse in benefits. There is no grace period.

12. Membership fees are not tax deductible.

13. I transfer directly to Pacific West my rights to ground insurance payments due to me for services provided by Pacific West Ambulance. Such payments shall not exceed Pacific West regular charges.

14. I specifically waive any and all rights, claims or causes of action against Pacific West and its employees and agents with respect to my LifeGuard Membership Program.

15. The Membership Program may be canceled at any time for any reason, including financial feasibility and governmental regulation of such programs.

16. No refunds will be issued on Membership purchases. Membership benefits are non-transferable.

Membership cards are not required in order to obtain service under your membership. You will receive confirmation that your membership has been processed. You will be active in our membership database, assuring that if transported, your membership will apply. Your membership cards and material will come separately after enrollment.

*All persons living in the same household and claimed as dependents on your tax forms.

** According to 2015 Pacific West Ambulance Service Transportation Records