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As a senior, driving might not be an option anymore. However, there still needs to be a way to get to all your non-emergency medical appointments. Unfortunately, Medicare does not usually cover transportation to get to normal appointments, such as general doctor visits. However, Medicare may cover non-emergency ambulance transportation services.
Medicare will cover emergency and non-emergency ambulance services. However, there are conditions and requirements that you must meet to qualify for Medicare coverage.
Medicare Part B (Medical Insurance) covers ambulance services to or from a hospital, critical care facility, or skilled nursing facility (SNF). Medicare covers and helps pay for ambulance services only when other transportation could endanger your health.
Coverage only includes ambulance services to the nearest appropriate medical facility that’s able to give you the care you need. You may choose a facility farther away. If so, Medicare’s payment will be based on the charge to the closest appropriate facility. No local facilities may be able to give you the care you need. In this event, Medicare will pay for transportation to the nearest facility outside your local area.
Emergency Ambulance Transportation
Emergency ambulance transportation to a hospital or skilled nursing facility (SNF) is available when you have a sudden medical emergency and other means of transportation aren’t safe (i.e., car or taxi).
Here are a couple of instances when Medicare might cover emergency ambulance transportation:
- You’re in shock, unconscious or bleeding heavily.
- You need skilled medical treatment during transportation.
These are only examples. Medicare coverage depends on the seriousness of your medical condition and whether you could’ve been safely transported by other means.
Medicare only covers air ambulance transportation in emergency situations, such as:
- Your pickup location is hard to reach by ground transportation.
- Long distances or other obstacles, like heavy traffic, could stop you from getting care quickly if you traveled by ground ambulance.
If you could have been safely transported by land ambulance without serious danger to your life or health, Medicare pays only the land ambulance rate and you are responsible for the difference.
Non-Emergency Ambulance Transportation
Medicare will partially cover non-emergency ambulance ground services if all of these apply to your situation:
- Ambulance transportation is needed to obtain treatment or diagnose your health condition.
- The use of any other transportation method could put your health in danger.
- You have a written order from your doctor stating that ambulance transportation is necessary.
If all of the above is true for your situation, then Medicare would pay 80%. You would cover the remaining 20% coinsurance and Part B deductible ($185 for 2019).
Does My Medicare Supplement Cover Ambulance Services?
Because Medicare supplements cover the remaining costs of Medicare-approved expenses, your Medicare supplement policy will cover part or all of the remaining cost for ambulance services, depending on which policy type you own.
All Medicare supplement plans cover all or part of your emergency and non-emergency ambulance Medicare Part B coinsurance, but only Plan C and Plan F cover your Part B deductible. Therefore, if the situation in which you used an ambulance meets the Medicare coverage criteria, and you own a Medicare supplement Plan F or C, you would pay no out-of-pocket costs for ambulance services.