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Can Medicare Cover Ambulance Services?

Medicare Bob
Medicare covers transportation by ambulance in many cases, but not all. Find out if you’re covered for an ambulance ride when you’re in need.
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According to the Centers for Disease Control and Prevention (CDC), about 30% of people ages 60 and over visit the emergency department by ambulance — and that number only increases with age. 

Fortunately, if you’re a Medicare beneficiary, you have options. Medicare Part B generally covers ambulance services to the nearest appropriate medical facility. Ambulance coverage may include transport to and from the following:

When Can Medicare Cover Ambulance Services?

Medicare only covers and helps pay for ambulance services when other transportation could endanger your health. For example, if you have a sudden medical emergency and your health is in serious jeopardy, an ambulance would likely be covered under Medicare Part B. 

Medicare is also likely to cover ambulance services when you become incapacitated, like if you have an accident and are unable to function normally. 

There are many health conditions that may require a trip to the emergency room, like:

  • Chest pain or difficulty breathing

  • Fainting, weakness or numbness

  • Broken bones

  • Head or eye injury

  • Severe cuts that may require stitches

Medicare may also cover ambulance transport to or from a dialysis facility if you have end-stage renal disease (ESRD). Most ambulance services can be covered by Medicare. However, in some cases, you may have to pay part or all of the costs.

What Ambulance Services Can Medicare NOT Cover?

Medicare will only cover transport to the closest facility that can provide the necessary care. So, if you instruct the ambulance service to go to a facility farther away, you may have to pay part of the cost. 

In the case that you request an ambulance to transport you from one facility to another to be closer to home or family, you may get a “Medicare Summary Notice” denoting your ambulance service is not covered.

When an ambulance company believes Medicare may not pay for your service, the company must give you an "Advanced Beneficiary Notice of Noncoverage."

When Can Medicare Cover Air Transportation?

In general, Medicare may pay for emergency ambulance transport in an airplane or helicopter if one of the following applies:

  • Your location is not easily accessible by ground transportation.

  • Long distances or obstacles could stop you from getting medical care quickly.

How Much Can Medicare Pay?

When Medicare covers your ambulance services, it pays 80% of the cost after you pay the annual Part B deductible. However, if a facility owned or operated by a critical access hospital transports you, the amount Medicare pays may differ.

A Medicare Supplement plan can help cover your out-of-pocket ambulance costs. You can shop Medigap plans with a licensed Medicare agent by calling Senior Healthcare Direct at 1-833-463-3262, TTY 711, or visit our website to get a quote.

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