Medicare covers emergency transportation when it’s medically necessary or reduces further health risk
Some Medicare Advantage plans may cover transportation to a doctor’s visit but Original Medicare does not cover non-emergency transportation
Like most Medicare services, you will be responsible for 20% coinsurance after your deductible
Typically, your Medicare plan will cover a portion of your costs if you require emergency transportation to a hospital or other medical facility. Medicare Part B covers emergency transportation by ambulance when:
- It’s medically necessary, and
- Riding in another vehicle would put your health at risk
In these cases, Medicare transportation coverage typically includes trips to a hospital, skilled nursing facility or critical access hospital when medical treatment is needed.
Since Medicare ambulance coverage is provided by Part B, it’s included in Original Medicare (Parts A and B) and Medicare Advantage (Part C) policies. Non-emergency transportation, on the other hand, is typically not covered by Original Medicare. Medicare Advantage plans may cover transportation to doctor appointments as part of their services.
Find a local Medicare plan that fits your needs
Not typically, but there are exceptions. So, when does Medicare cover transportation? In rare cases, Part B may provide Medicare transportation coverage if you need medically necessary treatment and have a note from a doctor. For example, patients with End Stage Renal Disease (ESRD) who need dialysis may qualify for rides to their treatments.
When it comes to costs, Medicare treats ambulance transportation like other medical services. You’ll pay a 20% coinsurance for Medicare-approved ambulance services. Medicare Part B covers the rest of the amount that’s Medicare-approved. Remember, this is for emergency and non-emergency services that have been deemed medically necessary by a doctor.
Can you claim ambulance on Medicare?
Since they’re covered by Part B, you won’t typically need to file a claim with Medicare when you receive ambulance services in emergency circumstances. You’ll be billed a coinsurance charge for the ride, which is 20% of the Medicare-approved cost.
Does Medicare cover ambulance service in non-emergency cases without a claim? If you have a written order from a doctor, Medicare transportation services may include limited, non-emergency rides in an ambulance if it’s medically necessary. If the service is not medically necessary, you may have to pay full price for the transportation.
If you need help with transportation and it’s not offered in your policy, you may be able to get assistance from Medicaid or a local Program of All-Inclusive Care for the Elderly (PACE) program.
Are you eligible for cost-saving Medicare subsidies?
Yes. Medicare ambulance coverage does include paramedics when dispatched for medically necessary emergency services. This includes paramedic intercepts or when paramedics meet the ambulance en route to the hospital. Often, the paramedics work for a different company than the ambulance driver. If Medicare is billed separately for the two services, you may receive an invoice for the paramedic services you receive. [i]
Does Medicare cover air ambulance service?
Medicare will often cover air ambulance services If you need immediate, rapid transportation to a medical facility and road transportation isn’t fast enough. In these cases, you may need to be moved via plane or helicopter. Like standard Medicare ambulance coverage, it needs to be medically necessary, and you’ll have to pay 20% coinsurance after you’ve met your deductible.