Ambulances are vehicles that transport patients to and from medical facilities, like hospitals. Ambulances are medically equipped and staffed by professionals like EMTs or paramedics. Let’s look at how Medicare covers transportation in ambulances.
Medicare Part B covers emergency ambulance transportation.
Medicare considers an emergency to be any situation when your health is in serious danger, and you cannot be transported safely in another way. There are certain requirements you must meet for Medicare to cover an emergency ambulance ride:
Medicare Part B sometimes covers non-emergency ambulance transportation.
You must meet one of two requirements to have your non-emergency ambulance ride covered:
Medicare may also cover scheduled and regular non-emergency ambulance transportation. To get this kind of transportation covered, your doctor must send the ambulance supplier a written order. The written order needs to state that the transport is medically necessary. It must also be dated no earlier than 60 days before the trip. In certain states, ambulance suppliers must also receive prior authorization from Original Medicare before providing scheduled, non-emergency transportation.
If Medicare denies coverage for your ambulance ride, you can appeal the denial. Contact your local State Health Insurance Assistance Program (SHIP) for guidance on the appeals process. Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
In limited cases, Medicare Part B covers transportation in an air ambulance.
An air ambulance is usually a helicopter that has medical equipment and is staffed by medical professionals. For Medicare to cover an air ambulance transport, the service must be medically necessary. This means that you require immediate and rapid ambulance transportation that could not be provided by a ground ambulance.
More specifically, air transportation must be needed either because:
Look out for ambulance fraud, errors, or abuse.
Here are some red flags to watch for:
If you believe you have experienced Medicare fraud, errors, or abuse, contact your local Senior Medicare Patrol (SMP).
Still have questions?
Your SHIP is here for you! You can contact your SHIP for any other Medicare-related questions or concerns you have. SHIP counselors are government funded to provide trusted, unbiased Medicare counseling at no cost to you. (Depending on your state, your SHIP may go by another name.) Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
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