Starting February 2027 Utility Billing Cycle

The City of Keene auto-enrolls all residents in a Medical Access & Service Advantage (MASA®) Essentials membership, with a voluntary contribution of $7.75 per month included in their monthly water bill. Residents who already have MASA, those on Medicaid*, or anyone who does not wish to participate must opt out by completing the form at the bottom of this page. For questions, you can call us at City Hall at 817-641-3336 and select Option 2.

Medical Access & Service Advantage (MASA) is the leading provider of emergency  transportation protection, built to shield you and your family against the out-of-pocket  costs associated with emergency ambulance transports and related expenses.  

The average bill for a ground ambulance ride is $2,185, and $72,115 for an air ambulance  ride.+ No one should have to worry about transport bills during or after an emergency.  Unfortunately — even for the insured — these costly bills have become a normal, expected  part of emergency care and continue to rise every year. 

MASA protects more than 2 million members against emergency and non-emergency  transportation and provides compassionate services for the challenges often faced after an  emergency. 

As a resident of Keene, you and your household are auto-enrolled in MASA Essentials with  your voluntary contribution of $7.75 per month. Your MASA Essentials plan includes:  

Emergency Ground Ambulance Transport Protection+
If you ever need an emergency ground ambulance, MASA will pay for your eligible out-of- pocket expenses up to $1,000. 

Emergency Air Ambulance Transport Protection+
If a first responder or doctor says air transport is medically necessary during your serious  emergency, MASA will pay for your eligible out-of-pocket flight expenses up to $10,000. 

Hospital to Hospital Ground Ambulance Transport Protection+
If your doctor orders a ground ambulance to move you to another hospital for specialized  care, MASA will pay for your eligible out-of-pocket expenses up to $1,000. 

Hospital to Hospital Air Ambulance Transport Protection+
If your doctor orders an air ambulance to transfer you to a different hospital with the  necessary level of care, MASA will pay for your eligible out-of-pocket expenses up to  $10,000.  

Treat and No Transport+
If emergency first responders are summoned to treat you during an emergency but  determine you don’t need to be transported, MASA will reimburse up to $200 for eligible  out-of-pocket expenses. (Limited to two reimbursements per consecutive 12-month period  beginning from plan effective date.) 

Your MASA membership includes you and your household members.  

Household members require a legally verifiable record of address that matches the  customer address for the Keene water services account and is dated on or before the date  of service for the member benefit being sought under the resident’s MASA membership.  

Acceptable records of address include a driver's license, mortgage statement, property  deed, rental or lease agreement, bank statement, or utility bill. 

Current enrollment in a high-deductible health plan (HDHP) that is compatible with a  health savings account under Internal Revenue Code section 223 may impact the  membership benefits you receive from MASA. It is important that you identify to MASA  if you are enrolled in such a plan by contacting MASA at 800-643-9023 and selecting Option 2 or by email at info@masaglobal.com.

Opt out or cancel your membership by completing the form at the bottom of this page.

Customers who already have MASA, are on Medicaid*, or do not wish to participate must opt out by January 15, 2027, to avoid the charge appearing on their February 2027 utility bill.

You can still opt out after January 15, 2027, by completing the form. However, if you opt out after the 15th of the month, the MASA charge may appear on your next utility bill.

If the MASA charge appears on your bill after you have opted out, call 817-641-3336 and select Option 2. We can remove the charge from your bill and help you opt out.

Requesting payment is easy. Within 180 days of the transport, submit your bill by either emailing it to ambulanceclaims@masaglobal.com — be sure to note your member ID in the  email — or by uploading it in the member portal online at masaaccess.com/member.  

Including your health insurance Explanation of Benefits along with your bill can help expedite the process. After submission, you’ll receive an auto-reply confirmation of receipt with basic details.  MASA representatives will review your request and reach out if they need more information. Once your request is closed, you’ll receive a letter notifying you of resolution.

You can also check the status of an existing claim in the portal at masaaccess.com/member, through the MASA app, or by calling 833-962-7222. 

Yes, you can re-enroll in the MASA Essentials Program at any time. Call Utility Billing at City Hall at 817-641-3336 and select Option 2, and let us know that you would like to re-enroll. Re-enrollment may be subject to MASA's then-current terms. 


DISCLAIMERS 

* Medicaid beneficiaries are ineligible for MASA memberships 

1: In the Continental U.S., Hawaii, and Alaska 

2: In the Continental U.S., Hawaii, Alaska, and Canada

+: MASA group business claims data, 2026. Based upon the enactment of certain legal protections regarding surprise medical billing, actual member liability may be less than the provider's charges. 

This material is for informational purposes only and does not provide any coverage. Not all MASA products and services are available to residents of all states. The benefits listed, and the descriptions thereof, do not represent the full terms and conditions applicable for usage and may only be offered in some memberships or policies. Based upon the enactment of certain legal protections, including the No Surprises Act, regarding surprise medical billing, actual member liability may be less than the provider's charges. For additional information and disclosures about MASA plans, visit info.masaglobal.com/disclaimers.

MASA Opt Out Form

Address (Must be the same as Service Address)

Before You Opt Out of MASA Essentials — Please Read Carefully

Effective February 1, 2026, the City of Keene is offering MASA Essentials, a voluntary emergency medical transport protection plan, to residents on their monthly utility bill. The cost is $7.75 per month and helps reduce out-of-pocket costs for emergency ground and air ambulance transports — up to $1,000 for ground and $10,000 for air, anywhere in the United States and Canada.

All utility customers are automatically enrolled unless they choose to opt out. By submitting this form, you are choosing not to participate in MASA Essentials.

By opting out, I understand and acknowledge that:

- I am declining MASA Essentials coverage for myself and the members of my household.
- Neither the City of Keene nor MASA will provide financial assistance toward any emergency ground or air ambulance bills I may incur on or after February 1, 2026, or starting my effective opt out date.
- Emergency ambulance transports — particularly air ambulance — can result in out-of-pocket charges of several thousand dollars, even with health insurance.
- This opt-out remains in effect until I notify the City that I wish to re-enroll. Re-enrollment may be subject to MASA's then-current terms.
- My opt-out request must be received by the 15th of the month to prevent the $7.75 monthly charge from appearing on my utility bill for the following billing cycle.
- The City of Keene is acting only as a billing facilitator. MASA Global is the provider of the protection plan, and all coverage terms, claims, and disclaimers are governed by MASA's plan documents available at https://info.masaglobal.com/disclaimers.
- I am submitting this opt-out voluntarily and on behalf of my household.