Why the big difference? Here are a few reasons. Jet fuel prices have not fallen nearly as much as gasoline prices. During these challenging economic times fewer people can afford an air ambulance flight thus the overhead costs rise to offset the fewer flight hours. Insurance costs have risen significantly along with the frequency of  helicopter accidents. Salaries for critical care flight nurses are among the highest for all nursing positions. Flight training and recurrent training costs for pilots continue to rise.  With fewer air ambulance companies operating there is less competition than even 2 years ago.

Therefore, only the most critical patients who may require invasive medical care and the shortest time in transfer are going by air ambulance, as they should.  However when time in transit is not a critical factor more and more people are choosing to go by medical ground transportation. Since insurance rarely covers the cost of medical transportation, assuming you did not buy a travel insurance policy before your accident, you too may decide to stay the ground.