Medicare Part B covers emergency ambulance services and, in limited cases, non-emergency ambulance services. Medicare considers an emergency to be any situation when your health is in serious danger and you cannot be transported safely by other means. If your trip is scheduled when your health is not in immediate danger, it is not considered emergency, and you will be responsible for paying the full out-of-pocket cost.
Eligibility Part B covers emergency ambulance services if:
- An ambulance is medically necessary, meaning it is the only safe way to transport you
- The reason for your trip is to receive a Medicare-covered service or to return from receiving care
- You are transported to and from certain locations, following Medicare’s coverage guidelines (see below)
- And, the transportation supplier meets Medicare ambulance requirements
To be eligible for coverage of non-emergency ambulance services, you must:
- Be confined to your bed (unable to get up from bed without help, unable to walk, and unable to sit in a chair or wheelchair).
- Or, need essential medical services during your trip that are only available in an ambulance, such as administration of medications or monitoring of vital functions
Original Medicare never covers ambulette services. An ambulette is a wheelchair-accessible van that provides non-emergency transportation. Medicare also does not cover ambulance transportation just because you lack access to alternative transportation. Medicare Advantage Plans must cover the same services as Original Medicare, and may offer some additional transportation services. Check with your plan to learn about the costs and coverage of non-emergency transportation.
Note: If you are receiving skilled nursing facility (SNF) care under Part A, most ambulance transportation should be paid for by the SNF. The SNF should not bill Medicare for this service.
As explained above, Medicare Part B covers ambulance transportation to and from certain locations. Part B-covered ambulance services to and from the following locations:
|Your home, or any other place where need arises||The nearest appropriate hospital or skilled nursing facility (SNF)|
|A hospital or SNF||Your home, if the hospital or SNF is the nearest appropriate facility|
|A SNF||The nearest medical provider if the SNF cannot provide you with necessary treatment and the cost of transport is less than bringing the treatment to and from you|
|Your home||The nearest appropriate renal dialysis facility and back|
If your area does not have a facility that can properly treat you, Medicare covers ambulance transportation to the nearest appropriate facility. Note, though, that Medicare will not pay for ambulance transport to a hospital outside your area so you can receive care from a particular doctor, if there is another hospital available to treat you nearby.
If you have a Medicare Advantage Plan, contact your plan to learn about coverage of ambulance transportation.
Under Original Medicare, Part B covers medically necessary emergency and non-emergency ambulance services at 80% of the Medicare-approved amount. In most cases, you pay a 20% coinsurance after you meet your Part B deductible ($185 in 2019). All ambulance companies that contract with Medicare must be participating providers.
If you have a Medicare Advantage Plan, contact your plan to learn about costs for ambulance transportation.
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