This^^. I’m familiar with a number of air ambulance stories. A friend fell off a camel in Uzebekistan. He broke a number of ribs which were complicated by the local hospital’s care/lack of care. His travel insurance for an air ambulance from Uzebekistan to Dubai, and then for a first class ticket with an accompanying nurse for the flight to the US when he was released from Dubai. Another friend has a child nearly drown and needed an air ambulance to get the child from Las Vegas (where the accident occurred) to Seattle. They had to pay $15K out of pocket. The air ambulance service billed their insurance carrier significantly more. While their cost was capped at $15K, the cap in place for air ambulance service mean the carrier only paid a portion and both payments did not equal the full bill.
My trainer took an air ambulance ride from a farm to the local hospital. I think her bills was $10K for a 20 minute flight. She did not have the money to pay and somehow she got the cost forgiven.