Does Medicare Cover Ambulance Cost – Overview?
Ambulance rides are quicker to reach the hospital. Yet, this medical transport is quite an expense. It may cost as much as a couple of hundred to a thousand dollars and more.
The cost of advanced care on the way to the hospital can incur costs of as much as US$ 2,000 and more. You can avoid this cost by choosing Medicare insurance plans.
Original Medicare usually covers the cost of hiring an ambulance. Still, there are some restrictions on medical transport under Medicare.
So, be ready to pay some out-of-pocket expenses for the ambulance rise.
Let’s take a detailed look at the types of Medicare cover for ambulance transport.
3 Types of Ambulance Services Medicare Cover
Medicare Part B covers the cost of ambulance transport during a medical emergency. This service is provided when other forms of transport are unsafe for the patient.
Medicare Advantage and other Medicare plans also offer cover for ambulance transport, but the coverage, rules, and cost vary according to specific Medicare plans.
Let’s look at the types of ambulance services that Medicare covers under emergency transportation:
1 – Emergency Ambulance Transport
Medicare Part B Medical Insurance usually covers standard emergency ambulance transport. This covers transporting patients to a hospital, skilled nursing facility, or critical care clinics.
These are all done under medically necessary services. Medicare considers the severity of the policyholders into account before paying the cost of ambulance transport.
Your cost might not be covered if you did not have need ambulance transport.
Medicare will usually approve ambulance transport requests in case of a medical emergency, such as after a road accident or serious injury.
2 – Emergency Air Transport
Medicare also pays for air ambulance costs in certain situations. Still, several criteria need to be met to avail air transport services under Medicare.
First, your health condition should warrant immediate evacuation by air to the nearest hospital. The main conditions which need to be met to avail air transport under Medicare are:
- You are at a location that is not accessible by a standard ambulance
- You are located far from a hospital and other obstacles may prevent you from reaching the hospital on time
For instance, imagine you are out hiking at a remote location and get seriously injured from a mishap.
If you are the injury is severe, such as suffering from internal bleeding, then you will be provided air transport under Medicare.
3 – Non-Emergency Transport
Usually, Medicare covers the cost of ambulance transport in emergencies. However, it also covers the cost of ambulance transport in non-emergency situations too, such as:
- Your doctor advises a medical transport
- You have a medically necessary reason to use an ambulance
People with end-stage renal disease get non-emergency ambulance transport under Medicare for their regular dialysis trips.
In case you suffer from severe obesity and are unable to travel in a car, then also Medicare will provide non-emergency ambulance transport.
How Much Cost Does Medicare Cover for Ambulance Transport?
Medicare usually pays 80% of the total ambulance transport costs, while you need to pay the remaining 20% from your pocket.
The amount is a fee schedule and changes according to the location. Still, ambulance transport costs are added to your Medicare Part B deductibles.
So, if you haven’t met your deductible, then get ready to pay the remaining amount in addition to the usual 20% co-insurance.
Most Medigap (Medicare Supplement Insurance) plans cover the cost of your Original Medicare deductibles and copayments.
Medicare Part B covers the cost of ambulance transport in emergencies. These include ground ambulances, or air ambulances when required.
In a few situations, Medicare will also cover the cost of ambulance services for non-emergency situations.
You need to pay 20% coinsurance after using this service with your Medicare insurance plans.