The information in this article only applies to people with Original Medicare or people with Original Medicare along with a Medicare Supplement. If you have a Medicare Advantage Plan or another type of plan, contact your plan provider.
Medicare Part B
Medicare Part B covers ambulance service to and or from a hospital, skilled nursing facility or a critical access hospital. Medicare will only help pay for an ambulance only when using any other type of transportation could endanger your health.
Depending on the situation, Medicare could cover ambulance services to a dialysis facility if you had End-Stage Renal Disease (ESRD).
Emergency Ambulance Services
You are able to get emergency ambulance transportation when you have has a medical emergency and your life is in danger because you cannot be transported safely in a car or taxi.
Some examples are:
- You are in shock, bleeding heavily, or are unconscious.
- You are in need of skilled medical treatment during transportation.
Medicare will only cover services to the closest suitable medical facility that is able to provide you with the care you need. If you choose to be taken to a medical facility that is further away, Medicare may not pay any additional charges.
If there are no local medical facilities, Medicare will pay for ambulance transportation to the nearest location that is outside of your local area.
Non-emergency Ambulance Transportation
You could be eligible for non-emergency transportation if you have an ailment and the use of other transportation would endanger your health. Sometimes Medicare may cover transportation if you have a written order from a doctor that ambulance transportation is necessary because of a specific medical condition.
Medicare may pay for air transportation if you have a condition that requires rapid and immediate transportation that ground transportation is unable to provide. In addition, one of the following must apply:
- Long distances or heavy traffic could prevent you from getting the care you need if you traveled by ground transportation.
- You are in an area that cannot be easily accessed by a ground ambulance.
What Will You Pay for Covered Services?
Like most Medicare Part B charges, Medicare will pay 80% and you or your Medicare Supplement plan will be responsible for the 20% that Medicare doesn’t pay after you or your Medicare Supplement plan have meet the annual Part B deductible.
Advanced Beneficiary Notice of Non-coverage (ABN)
If you request ambulance transportation for a non-emergency situation and the ambulance company believes that Medicare may not pay for the service, they can have you sign an ABN. The ABN states that you are responsible for paying for the service if Medicare does not pay.
Click the link to read or download the Medicare publication Medicare Coverage of Ambulance Services from my website.
We are Here to Help
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Medicare Explained in Plain English