Yes the pay is low to start, but you do move up the ladder relatively quickly with opportunities to fly some of the newer type of aircraft out there with pay increases!! Once you are in EMS it is very hard to get out.. the job is extremely fulfilling, i love working with the people, i have made friends with people worldwide and i am just a mechanic. No I don't work for Air Methods, but for another reputable EMS operator in the Chicago area and once you are in the door with them, they do take care of you. As for the pilot positions, the requirements are so high not because of the operator, or (believe it or not) insurance companies, but due to the Medical board of that particular state. Illinois requires 3000hours Helo, 2500 PIC, 1500 IFR now who in the world other than military pilots or someone who has a lot of money is going to have that amount of time. Especially in twin turbine helicopters and IFR time. If you don't love to fly, or enjoy your job, than it is not a good career choice. The dreams of anything over $100,000 a year only come with corporate flying an S76 somewhere around New York City.
Just putting my 2 cents worth in.