I am considering that option but after 20 years of living where the government tells me, I am reluctant to give up the geographic freedom that a pension can provide. I don’t want to commute and I can’t think of a major city that I want to live in.

In addition to the bullet points in my OP, one of my top choices of retirement locations has an air Ambulance service but it is a regional airport about a 3 hour drive to a major city.

My priorities are free time and living where I want first, pay second.

Your expectations are quite realistic and accurate for an air ambulance job. Depending on the operator, it is possible to get stuck out on overnights though. For a community operator, they usually fly 3 legs per patient. If you can pick up and drop off the patient within your duty time, returning to base might not happen. This was my turn off from my last job. Got tired of calling the wife saying I wouldn't be home that night.

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Thanks again for all the replies. I reached out to the company that services my first choice of retirement locations to get more information.
Maybe after I retire from the military and have a long vacation, I might be more motivated to chase an airline pilot paycheck. Right now the life of an Ambulance pilot sounds good to me.

Good luck with that.

Have a plan B.

Have a plan C, too.

I was an active Reservist and at a Legacy...furloughed after 9-11. Reserves were keeping us financially covered...then an air ambulance job opened up in my town.

My experience:

1. Most air ambulance companies are small. To keep costs down they are minimally staffed.

2. This means you are on a very short leash almost all of the time. FAR abuse or bending, I believe, is common. Two days off a week. Rest of the time...”resting,” but meant can’t have a beer, or do any real social planning. While it looked on paper that the pilots were getting scheduled rest...the reality was being on-call nearly 24/7/365.

3. Pay is mediocre, benefits not very good (you wouldn’t need them as a mil retiree).

4. Many of the operators make you pay for your training, or sign a contract.

5. I was astounded to find out how poor the training...and checkride histories....were of the other guys, compared to mil or airline. At least at the company I was with (four airplanes, about 16 pilots total), the pass rate on checkrides was 50%....and I mean recurrent, not just initial! (I passed!)

When I went for my first recurrent at a major (respected) sim company, I asked a systems question. I was shocked when the instructor and the highly experienced students in the class all had different opinions on how a system worked. I only had a hundred hours in the plane...but realized it was the blind leading the blind, and I probably knew the answer better than they did.

6. I’d say 80% of my flights started between 10:00pm and midnight. They’d finish at dawn. Exhaustion was a norm.

7. Maintenace at my company was pretty good...but at many places...tight budgets.

8. There can be “get there-itis” with a critical patient or organ transplant when wx or mx is iffy. I think this leads to a high accident rate in the air ambulance field.

9. I’ve helped load patients that weighed over 300 lbs. A miracle I didn’t ruin my back.

10. I’ve transported people with drug-resistant diseases, and wondered how safe I was being in the same tube for a couple of hours.

11. Landed in places with malaria...and we had no mosquito repellant.

12. FAA oversight varies from draconian to laissez-faire....even from the same Inspector.

12. The Lear 35 was a fun airplane but has a few quirks.

13. Overall: I have a few stories where I felt like what we did was altruistic and really helped someone out. But in light of the above, and the rampant abuse of medical insurance/Medicare by hospitals, doctors, and even the air ambulance companies...

I wish I had never done it, and just put in more time at my Reserve unit.

For you: I’d say corporate, at a decent-sized flight department, at a Fortune 500 company.

Just my 2-cents (a nickel with inflation). :p

I bet a cake doughnut that you never saw six figures doing it, either.

Your experience sounds typical for ambulance operators, though perhaps trending toward the upper end. There's considerably worse out there.

Helicopter operators can be far worse, and have a worse safety record.

can anyone speak to trends in the industry? Most of the negative experiences posted on forums I have read don’t seem very recent. I remember about 8 years ago when I first had the option of getting out of the military, my friends in the airlines were talking about how terrible the conditions were. With improvements being negotiated by pilot unions, it seem like the Air Ambulance industry would need to follow in order to compete.

MedEvac was great, I recommend it. I flew for AMC and it’s possible to hit 6 figures if you want to pick up extra flying but if not, enjoy the 12 hr shifts kicked up in your crew room. As a lead pilot I had a few extra duties. Easiest flying around

Yeah, it's all old experience. Nobody here would know what the real world is like today. You're absolutely right. It's all peaches and cream. Fly 3 hours a month, work six days, make six figures twice over, and there are girls in bikini's with palm fronds fanning pilots as they lounge eating grapes. It's really quite good.

Ambulance pilot unions?

I appreciate specific feedback from pilots with experience in this area, but if you don’t have anything to contribute besides snarky comments then why bother? Just trying to make everyone else as sour as you?