LifeMed Agreement

Western Lane Fire and EMS Authority
2625 Highway 101 / Florence, OR 97439

Administrative Office: 2625 Hwy 101 / Florence OR 97439


Coverage begins two (2) business days after acceptance of a properly completed application form with payment and extends through the next June 30th.

We hereby apply for membership in Western Lane fire and EMS Authority ~ LifeMed Membership Program for our home* for the LifeMed fiscal year from July 1 – June 30. We understand that the membership fee of $65.00 provides only medically necessary** pre-hospital care and ground transportation within the LifeMed reciprocal areas. We request that payment of authorized Medicare, Medicaid or any other insurance benefits be made on our home(s)* behalf, to the ambulance supplier for any service provided to us past, present or future. We agree to immediately remit the ambulance supplier any payment that anyone in my home* receives directly from insurance or any source whatsoever of the services provided to or by members of my home*, and we assign all rights to such payments to the ambulance supplier. (A copy of this form is as valid as the original.)

  • We understand that medical transportation is based on medical necessity, not on Membership status, and that the patient will be transported to the closest medically appropriate facility, as is required by law.
  • We understand that the Membership covers only ground ambulance transports in our reciprocal areas, which are medically necessary**. Please refer to the Reciprocal Participating Agencies list & map, for over 80 agencies throughout the state of Oregon.
  • We understand that LifeMed is NOT insurance, but after the primary and secondary insurances are billed. If any co-pays or deductibles remain, they will be written off.
  • We further authorize the release of medical information for the purpose of ambulance insurance billing for our home*.

Membership includes all persons who are permanent residents of the same family home, non-commercial residence, and living together as part of a family unit, living within LifeMed’s ambulance service areas. Roomers or boarders are excluded and required to obtain their own separate memberships. Membership benefits also include household members living in substitute care (ex: nursing homes or care facility). Anyone who joins a home after the membership goes into effect can be included under the membership two (2) business days after notification to us. Those persons who meet the membership definition and are listed on the membership record at the time services are rendered eligible for membership benefits.

Medically Necessary is satisfied when the “lack of transport” could place the patient’s health in serious jeopardy; could cause impairment of bodily functions; or another mode of transportation could endanger the health of the patient. LifeMed does not cover non-emergent transfers from the hospital to home or to a lower level of care.

DISCLAIMER: LifeMed membership is not intended to solicit Medicaid enrolled patients, and such membership constitutes a voluntary contribution only. Persons who receive welfare, Medicaid, Department of Medical Assistance Programs, or Oregon Health Plan medical benefits need not be members in order to have full coverage for services covered under these programs.

LifeMed Coverage Map

City locations and shading are approximate.

Visit our Participating Agencies page for a list of participating ambulance providers.

 Benefits subject to Term of Agreement of transporting provider’s membership program.

Subject to change without notice.

Participating Agencies

Albany Fire Department AmbulanceAlbany, OR 97321541-917-7700
Ashland Fire & RescueAshland, OR 97520541-482-2770
Baker City Fire DepartmentBaker City, OR 97814541-523-3711
Bay Cities AmbulanceCoos Bay, OR 97420541-269-1155
Bend Fire DepartmentBend, OR 97702541-322-6387
Black Butte Ranch RFPDBlack Butte Ranch, OR 97759541-595-2288
Blue Mountain Hospital Vol. AmbulanceJohn Day, OR 97845541-575-1311
Bonanza Quick Response TeamBonanza, OR 97623541-545-6649
Canby Fire District AmbulanceCanby, OR 97013503-266-5851
Cascade Locks Fire and EMSCascade Locks, OR 97014541-374-8510
Chemult RFPDChemult, OR 97731541-365-2255
Chiloquin Fire & RescueChiloquin, OR 97624541-783-3860
Clatskanie RFPDClatskanie, OR 97016503-728-2025
Columbia River Fire and RescueSt. Helens, OR 97051503-397-2990
Coquille Valley AmbulanceCoquille, OR 97423541-396-2232
Corvallis Fire DepartmentCorvallis, OR 97330541-766-6961
Crescent RFPDGilchrist, OR 97737541-433-2466
Crook County Fire & RescuePrineville, OR 97754541-447-5011
Crooked River Ranch RFPD Amb.Crooked River Ranch, OR 97760541-923-6776
Dallas Ambulance ServiceDallas, OR 97338503-623-2338
Dufur Volunteer AmbulanceDufur, OR 97021541-467-2818
East Umatilla County Health DistrictAthena, OR 97813541-566-3813
Eugene Springfield FireSpringfield, OR 97477541-726-3636
Falck NorthwestSalem, OR 97301 971-301-8637
Fossil Volunteer AmbulanceFossil, OR 97830541-763-4175
Glendale AmbulanceGlendale, OR 97442541-832-2900
Harney District EMSBurns, OR 97720541-573-3686
Hood River Fire DepartmentHood River, OR 97031541-387-5213
Jefferson County EMS DistrictMadras, OR 97741541-475-7476
Jefferson RFPDJefferson, OR 97352541-327-2822
Keizer Fire DistrictKeizer, OR 97303503-390-9111
Keno Fire Department AmbulanceKeno, OR 97627541-883-3062
Klamath County Fire District #1Klamath Falls, OR 97601541-885-2056
La Grande Fire DepartmentLa Grande, OR 97850541-963-3123
La Pine RFPDLa Pine, OR 97739541-536-2935
Lane Fire AuthorityEugene, OR 97402541-688-1770
Lebanon Fire DistrictLebanon, OR 97355541-451-1901
Lower Umpqua EMSReedsport, OR 97467541-271-2171
Lyons Rural Fire Protection DistrictLyons, OR 97358503-859-2410
Marion County Fire District #1Salem, OR 97301503-588-6428
McMinnville Fire DepartmentMcMinnville, OR 97128503-435-5800
MedCom Ambulance AuthorityRoseburg, OR 97470541-440-3806
Medix Ambulance Service, Inc.Warrenton, OR 97146503-861-5558
Mid-Columbia Fire & RescueThe Dalles, OR 97058541-296-9445
Milton-Freewater EMSMilton-Freewater, OR 97862541-938-7146
Mist-Birkenfeld RFPDMist, OR 97016503-755-2710
Molalla RFPDMolalla, OR 97038503-829-2200
Morrow County AmbulanceHeppner, OR 97836541-676-9133
Myrtle Point AmbulanceMyrtle Point, OR 97458541-572-2993
North Douglas County Fire-EMSDrain, OR 97435541-836-2282
North Gilliam MedicArlington, OR 97812541-454-2888
Oakridge Fire Department AmbulanceOakridge, OR 97463541-782-2416
Pacific West Ambulance ServiceNewport, OR 97365541- 265-3175
Parkdale RFPDParkdale, OR 97041541-352-6092
Pendleton Fire Dept AmbulancePendleton, OR 97801541-276-1442
Polk County Fire District #1Independence, OR 97361503-838-1510
Port Orford Community AmbulancePort Orford, OR 97465541-332-0384
Powers Ambulance AssociationPowers, OR 97466541-439-3331
Rager Emergency Services, LtdPaulina, OR 97751541-477-3237
Redmond Fire & RescueRedmond, OR 97756541-504-5012
Rocky Point Fire & EMSKlamath Falls, OR 97601541-205-4934
Rogue River RFPDRogue River, OR 97537541-582-4411
Salem Fire DepartmentSalem, OR 97302503-588-6238
Scappoose RFPDScappoose, OR 97056503-543-5026
Sheridan Fire DistrictSheridan, OR 97378503-843-2467
Sherman County AmbulanceMoro, OR 97039541-565-3100
Sisters-Camp Sherman RFPDSisters, OR 97759541-549-0771
South Gilliam County Amb.Condon, OR 97823541-384-5555
South Lane County Fire & RescueCottage Grove, OR 97424541-942-4493
Southern Wasco County AmbulanceMaupin, OR 97037541-395-2598
Springfield (& Eugene) FireSpringfield, OR 97477541-726-3636
St. Paul Vol. Fire Dept. AmbulanceSt Paul, OR 97132503-633-4602
Sunriver Fire Department-AmbulanceSunriver, OR 97707541-593-8622
Sutherlin Fire DepartmentSutherlin, OR 97479541-459-1394
Sweet Home Fire and AmbulanceSweet Home, OR 97386541-367-5882
Tillamook AmbulanceTillamook, OR 97141503-815-2260
Tualatin Valley Fire and RescueTigard, OR 97223503-259-1125
Turner Fire District AmbulanceTurner, OR 97392503-743-2190
Umatilla County Fire District # 1Hermiston, OR 97838541-567-8822
Umatilla Tribal Fire DepartmentPendleton, OR 97801541-276-2126
Union Emergency ServicesUnion, OR 97883541-562-5197
Wallowa EMSEnterprise, OR 97828541-426-3111
West Valley Fire DistrictWillamina, OR 97396503-876-2004
Winston-Dillard Fire District #5Winston, OR 97496541-679-8721
Woodburn Ambulance ServiceWoodburn, OR 97071503-982-4699

Frequently Asked Questions

Q. How can I sign up for LifeMed?
A. Open enrollment is year round, but it is an annual program, and therefore extends through June 30th each year. You can enroll right here online or pick up an applications at Western Lane Ambulance District’s Admin office, Peace Harbor Hospital, Peace Health Siuslaw Region Clinics, or call 541-997-9614 and we will mail an application to you.

Q. If I don’t belong to the Membership Program will the ambulance still come if I call 911?
A. Absolutely, we will still provide you and your household with excellent service. The Membership Program only has to do with the billing portion, of how we charge for our service.

Q. Is Western Lane Ambulance LifeMed Program part of the FireMed program?
A. Yes, we work as an independent agency but participate with 80+ reciprocal FireMed Agencies in the State of Oregon. A list of participating agencies has been enclosed in this packet.

Q. Who does the membership cover?
A. (See Agreement) Membership includes all persons who are permanent residents of the same single-family occupancy, non-commercial residence, living within LifeMed’s ambulance service areas, living together as part of a family unit, including domestic partners, but not to include temporary stays or boarders; those which are listed on the membership application. Membership benefits include household members living in substitute care (ex: nursing homes). Others not included in this definition are required to obtain their own separate memberships.

Q. Is it insurance?
A. No, it is a paid subscription to the ambulance membership program.

Q. When does the Western Lane Ambulance LifeMed Membership expire each year?
A. All Western Lane Ambulance “LifeMed Membership’s” extend through June 30th each year; regardless if you sign-up in July or January.

Q. What does Western Lane Ambulance LifeMed Membership pay for?
A. LifeMed covers the co-pay, deductible or limitations on your policy that your insurance doesn’t always cover for medically necessary (See Agreement) pre-hospital care and ground transportation only which . We accept your insurance, Medicare or third party payer as payment in full, even if your insurance doesn’t pay the full cost of the transport. In the event you have no insurance, you are still covered under the LifeMed program.

Q. Does it cover transportation to hospitals in other cities?
A. Federal law requires the patient be taken to the nearest appropriate facility. However, if the Emergency Room or admitting physician deems ambulance transport to a different hospital is in the best interested of the patient – yes, LifeMed covers the co-pay or deductible.

Q. Does Western Lane Ambulance LifeMed Program coverage include out-of-state ambulance services?
A. No, it only covers our local service area and those of the Reciprocal Agencies participating through FireMed throughout Oregon.

Q. Is the $65 membership fee ever refundable or prorated should I move out of the Florence area?
A. No. Once you have paid the membership fee for the current year, no refund is given and no prorate of service is offered at this time.

Q. What type of service does Western Lane Ambulance LifeMed Program not cover?
A. Western Lane Ambulance LifeMed does not cover non-emergency ambulance calls; such as trips from a nursing home to routine dialysis treatments or visits to your doctor, or non-emergency transportation from a medical care facility.

Membership translates into significant savings and is a very smart investment in peace of mind for you and your family.

Your privacy is important to us. Please be assured Western Lane Ambulance District does not
sell, rent, or trade your personal information to others.

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