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Does Medicare cover ambulance services?


​Yes, while Medicare covers emergency and some nonemergency ambulance services, not every ambulance ride is covered.

In an emergency, the last thing you need to worry about is whether Medicare will cover your ambulance or emergency medical transport (EMT) service. But it’s good to know before you call 911 that Medicare covers ambulance services in limited circumstances.

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Emergencies. When you’ve had a sudden medical emergency and your health is in serious danger.

In this case, Medicare will cover ambulance transport if you require medically necessary services at a hospital or skilled nursing facility but can’t be safely moved otherwise. This may include emergency medical situations when you’re in shock or unconscious, bleeding heavily or need skilled medical treatment while in transit.

Air transport. Medicare may pay for an emergency flight by plane or helicopter if the trip would take too long on the ground and endanger your health.

In this case, Medicare will cover ground or air transit to what it considers the nearest appropriate medical center. If you choose to go farther away, Medicare will pay to get you to the closest place that can give you the care you need, but you’ll have to pay the rest.

Some nonemergencies. Medicare may also cover ambulance transportation in some cases when you’re not facing a medical emergency. But to receive this coverage, your doctor needs to write an order stating that an ambulance is medically necessary because other ways to get you to an appointment could endanger your health. For example, if you’ve been diagnosed with end-stage renal disease, Medicare may pay if you have a doctor's order stating that it is medically necessary for you to use an ambulance to take you to and from a dialysis center.

Today, all 50 states and several territories require prior authorization for regularly scheduled, nonemergency ambulance services.

How much do I pay for covered ambulance services?

Medicare Part B covers qualified ambulance services after you pay the annual Part B deductible, which is $240 in 2024. You’ll also be responsible for a 20 percent copay of the Medicare-approved amount.

If you have a private Medicare supplement policy, also known as Medigap, you’ll have coverage for the 20 percent Part B coinsurance.

Medicare Advantage plans cover emergency ambulance services but they could have different copayments — such as $245 or $260 per trip. Your provider may need to get prior authorization for nonemergency ambulance services.

Medicaid and Medicare Advantage plans may provide some nonemergency transportation benefits beyond what Medicare covers. For example, some Medicare Advantage plans pay for round trips to a specified number of scheduled doctor appointments.

Keep in mind

If you want to use an ambulance when you’re not facing an emergency but ambulance service officials believe that Medicare won’t cover the transportation, the service may be required to give you an advance beneficiary notice of noncoverage (ABN) This form states that you may be responsible for the entire bill.

If you receive a noncoverage notice, you need to check a box on the form for one of three options:

  • You want the service and want the provider to submit a claim to Medicare. If Medicare denies the claim, you have a right to appeal. You’ll receive information about the denial and instructions for filing an appeal in your Medicare Summary Notice.
  • You want the service but don’t want the claim sent to Medicare.
  • You choose to forego the service.
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ABNs for ambulance services can get complicated. The ambulance company must give you a notice if Medicare usually covers the service but expects that Medicare won’t pay because the method isn’t medically necessary.

This could occur if you want a helicopter flight when a ground ambulance could safely take you. However, ambulance companies can’t require you to sign an ABN for what Medicare considers emergency services.

There’s more. The ambulance company is not required to give you an ABN if you request a service that Medicare doesn’t cover, such as calling an ambulance when you’re not in an emergency situation and don’t have a doctor’s order allowing the transit.

For example, if you hurt your ankle and your health won’t be in danger if you go to the emergency room in a car but you choose to call an ambulance instead, the ambulance company may voluntarily give you an ABN to let you know the service likely won’t be covered. However, this isn't required by Medicare.

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