10/21/2026
The Cost of EMS
What do you expect from your local ambulance service, and what are you willing to pay to make sure it's there when you call?
Lyndon Rescue's main job is emergency medical care for the nine communities we serve. We also handle transfers to specialized hospitals, teach CPR and first aid, run car seat inspections and help families get child safety seats, cover regional events, and back up neighboring EMS services. We charge for courses and event coverage, but those fees only pay for those services. They don't fund the ambulance service itself.
The equipment is expensive. A new Type I ambulance, the kind most services here use because of our terrain and winters, starts around $250,000. We run three and replace each about every 10 years. Because of manufacturing backlogs, we have to order up to three years ahead. A powered stretcher costs about $35,000, and a cardiac monitor can top $60,000. Fully equipped, one ambulance can approach or exceed half a million dollars, and that's before insurance, maintenance and repairs.
Supplies add up too. We carry dozens of medications, and when they expire unused, they still have to be replaced. Oxygen, IV supplies, airway equipment and bandages all have to be on hand whether we use them or not.
Our biggest cost is people. Nearly two dozen EMS providers staff our ambulances. They have families and mortgages like everyone else. We pay competitive wages, offer benefits to full-time staff, and pay for training and certification so we can keep good people. An ambulance doesn't help anyone without a qualified crew.
Most of our revenue comes from billing insurance. We set our rates to reflect our costs while keeping in mind patients who are uninsured or underinsured. But insurers and government programs set their own rates. They often pay well below what we bill, and well below what it costs to keep a service ready around the clock.
We're not alone in this. A 2023 study by the University of Southern Maine's Maine Rural Health Research Center looked at a basic rural service: one ambulance staffed around the clock, a second on call, a chief, and a 25-minute travel radius. It estimated that such a service costs about $1 million a year in the smallest communities and $2.25 million in communities handling 1,500 to 2,200 calls a year. Lyndon Rescue answers nearly 1,600 calls a year.
Closer to home, the Vermont EMS Advisory Committee's December 2025 statewide assessment found that Vermont's ambulance services cost about $98 million a year to run, while insurance pays about $53 million, roughly 54%. Towns, other funding sources and volunteers make up the rest.
What we're asking communities to fund is readiness. That means crews on duty, ambulances maintained, and medications stocked 24 hours a day, whether we get ten calls or none. Transfers add to that cost. A single transfer can take a crew out of the area for four hours or more, so we staff a second ambulance about half of each week to keep local coverage.
Vermont recognized EMS as an essential service in 2024 through Act 157, but the recognition didn't come with funding. We don't expect fire departments or police to cover most of their costs by billing the people they help, yet that's what we expect of ambulance services. EMS is a public service, not a healthcare business that should pay for itself.
When you see EMS funding in your town budget, you're paying to make sure trained people and the right equipment show up when a neighbor, friend or family member has an emergency. Help us keep Caring for the Kingdom.
Sources
University of Southern Maine, Maine Rural Health Research Center (2023). A Consensus Panel Approach to Estimating the Start-Up and Annual Service Costs for Rural Ambulance Agencies. https://digitalcommons.usm.maine.edu/ems/17/
Vermont EMS Advisory Committee (December 15, 2025). Vermont Emergency Medical Services System Assessment.https://www.healthvermont.gov/sites/default/files/document/eprip-EMSAC-Final-Report-2025.pdf
