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Does Medicare Cover Ambulance Transportation


In the case of an emergency, Medicare will cover an ambulance ride to the hospital. Medicare only covers non-emergency ambulance transportation in certain situations.

Medicare pays for an ambulance when not taking it would risk your health. Understanding Medicare coverage for ambulance services can prevent an unexpected bill later.

So, in the content below, we’ll discuss the coverage, guidelines, and details of ambulance coverage through Medicare.

Also, we’ll go over other important facts that you’ll need to know.

Does Medicare Cover Ambulance Services

Medicare pays for an ambulance to take you to the nearest facility that can treat you. Often, that’s the closest hospital to the place where you were injured or became ill. But Medicare may pay for transport to a more distant hospital if you need special care or if there are no available beds at the closest hospital.     

What is the Medicare Approved Amount for Ambulance Services?

The Medicare-Approved amount depends on the state, situation, and specific billing code. For example, the ambulance will likely charge more per mile in rural areas than urban areas. Also, the bill could be higher when you need care while in the ambulance, such as stabilization.     

How Much Does Medicare Pay for Ambulance Services?

Medicare pays for ambulance services the same way it pays for other Part B care. You must first meet an annual deductible. Then, you’ll pay a portion of the costs. Ambulance companies can’t charge extra fees for services. Not allowing Part B Extra Charges means the ambulance must accept Medicare’s price as payment.     

Does Medicare Cover Air Ambulance?

Ambulance coverage includes airplane and helicopter ambulances. Part B will leave you with copays and any applicable deductibles. You may need an air ambulance if you’re in a remote area, such as hiking in an area that isn’t accessible by ground ambulance. As with ground ambulances, Medicare covers transportation to the nearest facility that can treat you.
 

What are the Medicare-approved amounts for international air ambulance services?

Medicare doesn’t usually pay for care outside the United States, including ambulance services. Medicare will pay for international care in a few situations. These include emergencies near the U.S. border, where the closest hospital is in another country.Also, some emergencies on cruise ships and while traveling between the continental U.S. and Alaska. 

It may be wise to buy a travel insurance policy if you plan to go outside the United States.

How to Submit an Ambulance Bill to Medicare

The ambulance may bill Medicare. Also, you may pay for the ambulance up-front and submit for reimbursement later. If you need to submit the bill to Medicare, follow these guidelines. Also, be sure to include an itemized invoice and records showing the ambulance trip was medically necessary.     

Does Medicare pay for non-emergency medical transportation?

Your doctor must verify that an ambulance is necessary. Meaning you couldn’t travel by another method. For example, a patient with End-Stage Renal Disease going to a dialysis facility MIGHT qualify for a scheduled ambulance ride to dialysis.     

But, if an ambulance operator believes Medicare may not pay, they must give you an “Advance Beneficiary Notice of Non-coverage“.

The record informs you that you’ll pay the full bill.

What is an Advance Beneficiary Notice of Non-coverage?

An Advance Beneficiary Notice is a document stating that in the event Medicare doesn’t cover your service of transportation, you agree to pay the bill. The document must show you understand, agree, and still want to receive ambulance services.     

The form is incomplete until you provide your signature. In an emergency, you’ll never get a notice.

You may choose to skip transportation services after getting a notice. If you refuse to sign the notice but take a ride in an ambulance, you’ll be responsible for the cost.

What is a Voluntary Advance Beneficiary Notice of Non-coverage?

If an ambulance goes to a non-emergent incident, the company might give you a voluntary notice. The difference from a non-voluntary Advance Beneficiary Notice is, the voluntary notice doesn’t require a signature.     

When an ambulance company gives you a voluntary notice, they expect that Medicare won’t cover the costs. So, they’ll give you a form to sign saying you understand.

Does Medicare Advantage Cover Ambulance Services

Medicare Advantage plans have different coverage options for ambulance services. Individuals with Advantage plans often end up owing less than those with Medicare. You’ll pay the Part B coinsurance and deductible. Advantage enrollees may only pay a copay and have no deductible.     

If you’re unsure how your policy works, you may always refer to your Summary of Benefits.

FAQ’s

Does Medicare cover transportation to doctor's appointments?
Medicare doesn’t usually cover transportation. But, in some cases, Medicare may cover non-emergency ambulance transportation to and from a doctor.
Does secondary insurance cover the cost of an ambulance when Medicare does not?
There are a few types of secondary insurance that may help pay for an ambulance. Coverage could come from ambulance insurance and travel insurance. Also, some Medigap plans may cover ambulance rides outside the United States.
Does Medicare pay for ambulance transportation?
Ambulances can take patients from one facility to another. Part B may cover this type of transportation. But, only if it’s necessary and only to the nearest facility. If you go to a hospital that can’t handle your situation, Medicare pays for an ambulance to the nearest hospital that can treat you. So, if doctors determine you need treatment in a burn unit, Part B covers transportation to the closest hospital that has one. Medicare won’t pay for an ambulance to a different hospital for the ability to be treated by specific doctors or to be close to your family.
Does Medicare cover Life Flight?
Life Flight is a membership-based insurance program that pays for ambulance costs in parts of the Pacific Northwest. Medicare doesn’t cover Life Flight’s membership dues. But, if you’re a Life Flight member and your ambulance meets terms, Medicare pays its portion. Life Flight pays after Medicare.

How to Get Medicare Coverage for Ambulance Services

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Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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