Medicare Coverage for Ambulance Services

What services do ambulances offer?

Ambulance services provide emergency medical care when you are injured or seriously ill. Paramedics or emergency medical technicians take care of you on the way to the hospital. They are supervised over the radio by emergency room doctors. Ambulances may also take you to and from some healthcare facilities when you cannot travel by other means due to your health.

What is Medicare?

Medicare is a federal government program. It provides healthcare coverage for people 65 or older, or for people of any age who have certain disabilities.

Medicare is divided into 2 parts: Part A and Part B. Each part covers different services. Both parts pay toward costs for services that are necessary for medical reasons. Both parts pay toward home healthcare if certain conditions are met.

Medicare Part A covers:

• inpatient hospital care
• skilled nursing facilities
• hospice care.

Medicare Part B covers:

• doctor visits
• lab and X-ray services
• durable medical equipment
• ambulance services
• outpatient hospital care.

Rules about what Medicare covers can be confusing. Rules also change from time to time. The premium (monthly amount of money you pay for Medicare Part B) can change every January. The deductibles (what you must pay before Medicare begins to pay), and the copayments (the percentage of costs you must pay) may also change. Your local Social Security office can answer your questions about Medicare.

Does Medicare cover ambulances?

Medicare covers ambulance services under Part B when:

• the care or ride is certified by a doctor as medically necessary
• the ambulance company is certified (has met Medicare requirements)
• transportation by any other means could endanger your health.

How much do I pay for ambulances services?

Medicare will pay 80% of an ambulance bill that it approves. You pay the remaining 20%. You must also meet your deductible for the year.

In some cases, you may be billed additional fees by the ambulance service. This occurs if the ambulance service does not have a contract with Medicare to accept the amount Medicare pays as payment in full.

Some ambulance companies offer memberships. As a member, you pay a set amount each year to belong. After you use the ambulance, the company bills Medicare and you do not pay the 20%. Check with your local ambulance service about specific details.

For more information, call Medicare toll-free at 1-800-638-6833.