AMERICANS who call 911 and get life-saving medical treatments could have a whopping $427 fee waiting on them after they recover.

California fire departments have started sending out massive insurance bills if they respond to medical emergencies.

The San Jose Fire Department reported that two-thirds of its calls required medical care, and they’re hoping to recoup those costs, local Fox affiliate KTVU reported.

San Jose’s city council recently approved the first responder fee plan.

The fee would only be applied when the fire department provides care comparable to that of hospital workers.

“What we are looking at is a trend line that is very concerning,” San Jose Mayor Matt Mahan told KTVU.

“Our fire department is responding to more and more medical calls where they are performing health care services, medical services, out in the field.”

San Jose firetruck driving down a street.

Mahan said it’s for the “sustainability” of the fire department.

“All we are saying is for the sustainability of our department, we need to be able to bill insurance when it is available to collect or recover the cost of providing medical care out in the field,” Mahan said.

San Jose isn’t the first Californian city to implement such a fee.

In the 1990s, California approved cities charging Americans similar first responder fees, and now, more than 20 cities in the state do so.

The fees range from $338 in Napa to as high as $567 in San Francisco.

San Jose’s fees will be $427 and will go into effect on January 1, 2026.

Some council members had expressed their concerns that the high fee will deter residents in danger from calling 911.

However, after careful research, the fire chief, Robert Sapien, said it wouldn’t.

Dispatch operators working at a 911 call center.

“None reported a detrimental effect to 911 access. We didn’t hear anyone say that we implemented this program and then people became fearful or leery of calling,” Sapien said.

San Jose resident Elijah Gardere argued with the chief, saying it will “definitely” have an effect.

“Definitely some might have some hesitation based on their insurance or if they even have insurance,” Gardere said.

The $427 bill will be sent to the insurance company, not the individual citizen.

“If it is not recoverable, we are not going after folks,” Mahan said.

“We are not sending debt collectors, it is not going to ding your credit, we are not interested in collecting directly from residents.”

The new fee is expected to generate an annual revenue of $4 million to be put back into the fire department.