Ambulance rides are not cheap, they can range anywhere from hundreds to thousands of dollars. During a medical emergency, the last thing you want to worry about is if Medicare will cover the large ambulance bill. Thankfully, Medicare does cover ambulance rides so you don’t have to worry about anything but receiving the care you need. In fact, Medicare pays over $5 billion for ambulance service claims every year. However, to receive these benefits, there are stipulations you should be aware of first.
Eligibility Under Medicare Part B
Medicare Part B covers emergency ambulance services, and in some cases will also cover non-emergency services. An emergency is considered any situation in which your health is in serious danger. If you schedule your ambulance ride, then it is not considered an emergency. To receive coverage from Medicare:
- The ambulance service must be medically necessary, and the only way to safely transport you to the hospital.
- The transportation supplier (meaning nursing care facility or any provider asking for ambulance services) must meet Medicare ambulance requirements.
- The reason for the trip must be to receive a Medicare-covered service during transportation or to return from receiving Medicare-covered care.
If the situation is not an emergency, then ambulance services will only be covered if:
- You are confined to your bed and unable to get up.
- You need medical services during the trip that are only available in an ambulance.
- You live in a skilled nursing facility and your doctor has written an order for an ambulance. You might be required to produce the order within 48 hours of the transport.
- Your doctor deems that ambulance transport is medically necessary and provides a written order ahead of your scheduled trip.
Be aware that if you ask first-responders to take you to a hospital or facility other than the one that is closest to you, Medicare will only cover the cost of a ride to the nearest hospital or facility. You will be responsible for paying the rest of the bill out-of-pocket.
Medicare will also cover other modes of emergency transportation, including ambulance flights. In order for Medicare to cover an ambulance flight, a ground ambulance must be unable to make it to your location. Medicare will also approve a flight if a ground ambulance can make it to the location but the situation is unsafe for the crew.
As with many services, Medicare Part B covers 80% of ambulance services, leaving you to pay 20% coinsurance out-of-pocket after you meet your Part B deductible ( $198 in 2020). It is illegal for ambulance companies to apply excess charges to your bill.
Some Medicare Supplement Plans will cover your coinsurance payments, so if you have certain letter plans, then ambulance rides will be covered 100%.
Ambulance rides are mostly covered by Medicare, but if you are worried about coinsurance payments, then consider a Medicare Supplement Plan. These plans mean that you won’t have to face Medicare bills alone, allowing you peace of mind, while at the same time putting money back in your wallet. There are different types of plans to choose from, with different coverage options at different price points. If you’re unsure where to begin, EZ can give you free quotes and a breakdown of all the plans. One of our agents will compare all of your options and find the perfect plan for your budget and needs. To get your free Medicare Supplement Plan quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-753-7207.