Enrolling in the LifeSaver Membership Plan helps cover the cost of emergency (9-1-1) ambulance service for Richmond
City residents from January 1, 2026 through December 31, 2026. Please complete the online form and submit payment following the
directions below. RAA will process your application within a few weeks.
Patient Privacy: RAA cares about protecting its patients’ privacy. In accordance with the Health Insurance Portability & Accountability Act (HIPAA) of 1996, RAA will provide you with an explanation of your patient rights and how your medical information will be used by the Authority. Please read RAA’s Privacy Practices. If you have any questions, call the business office at 804-254-1150.
MEMBERSHIP FEES AND BENEFITS
The Richmond Ambulance Authority (RAA) LifeSaver Membership Plan (PLAN) provides a reduction in member’s costs for any
emergency transport during the membership year. With or without insurance coverage, the PLAN provides up to a $350 balance
reduction and 20% discount off the remaining balance.
EFFECTIVE DATES
I understand my membership is effective upon receipt by RAA of full payment ($62 for an individual or $99 for a family) and signed membership agreement for the period January 1, 2026, through December 31, 2026. Applications received by RAA after the start of the membership year will become effective 30 days after receipt and the fee will not be prorated. To get the maximum membership benefits, make sure your application and payment is postmarked by December 31, 2025.
MEMBERSHIP TERMS
- I understand the PLAN covers members listed on the application, and that a family is defined as the member and their relatives who permanently live at the member’s physical place of residence (same household).
- I understand that the member is responsible for notifying RAA of the addition of any dependents during the membership year due to birth, adoption, or marriage. Benefits for dependents added after January 1, 2026, become effective 30 days after receipt of notification of the change by RAA.
- I understand the PLAN is only open to residents that live within the city limits of Richmond, Virginia.
- I understand Medicaid recipients do not need to enroll in the LifeSaver Plan.
- I understand the PLAN does not cover non-emergency transports.
- I also understand this membership is non-transferable and the fee is non-refundable.
- I acknowledge I am responsible for payment of ambulance services for me or my dependents regardless of insurance coverage. I understand the PLAN is not insurance and RAA will claim payments from my insurer or third-party agency (e.g., Medicare). I understand I may be asked to help RAA collect these benefits or payments. If I receive payment directly from an insurance company, I will immediately forward the payment to RAA under this agreement.
- I, the undersigned, request payment of authorized benefits be made on my behalf to Richmond Ambulance Authority, 2400 Hermitage Road, Richmond, VA 23220 for any ambulance services provided to me by Richmond Ambulance Authority.
- I authorize any holder of medical information or documentation about me to release to the Centers for Medicare and Medicaid and its Agents and Carriers, as well as to Richmond Ambulance Authority, any information or documentation needed to determine these benefits or benefits payable for related services provided to me by Richmond Ambulance Authority, now or in the future.
- I certify I have read and agree to the terms of the membership agreement.
After submitting the LifeSaver application, you can submit payment by clicking on the “pay now” button below. Please enter “LifeSaver Application” in the “Run/Account Number” field and submit payment ($62 for Individuals, $99 for families).
If you have any questions or concerns, please contact us.