Seeing as how I work for a private service, I can give you some insight. We do "emergency" runs for local nursing homes and medical centers (immediate care centers, doctors' office, etc). We also provide transportation for people who require oxygen, suction, or other interventions that can't be done in a taxi. As for the money aspect, most insurance companies require a medical necessity form from a doctor. Medicare still only pays something like 80-85% of the total cost. So I guess you could say we are a "kinda for profit" ambulance service!