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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:

  • First, the ambulance must be medically necessary. This means it is the only safe way to transport you.
  • Second, the reason for your trip must be to receive or to return from receiving Medicare-covered care.
  • Third, you must be transported to and from certain locations. For example, from your home to the nearest hospital. Or, from a skilled nursing facility to your home. Medicare will only cover your ride to a medical facility when it’s the nearest appropriate facility that’s able to give you the care you need.
  • Finally, the transportation supplier must meet Medicare’s ambulance requirements. For example, the ambulance must be staffed by at least two people.

Medicare Part B sometimes covers non-emergency ambulance transportation.

You must meet one of two requirements to have your non-emergency ambulance ride covered:

  • One, you are confined to your bed. This means you are unable to get up from bed without help, unable to walk, and unable to sit in a chair or wheelchair.
  • Or two, you need vital medical services during your trip that are only available in an ambulance. For example, you may need medications administered during the trip or need your vital functions monitored.

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:

  • Ground ambulance cannot get to you where you are,
  • Or there is a great distance to travel or another obstacle involved in getting you to the nearest appropriate facility.

Look out for ambulance fraud, errors, or abuse.

Here are some red flags to watch for:

  • You were transported in an unapproved ambulance like a taxi or rideshare.
  • Your ambulance was not staffed by two EMTs.
  • An ambulance company billed for more mileage than the actual distance of your ambulance trip.
  • An ambulance was ordered for you, even though it wasn’t medically necessary for you.
  • You were transported from your house to a non-covered destination, like your doctor’s office or a community health center.

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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