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 healthcare facilities when your health prevents you from traveling by other means.

What is Medicare?

Medicare is a federal government program. It provides healthcare coverage for people age 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 medically necessary. Rules about what Medicare covers can be confusing. Rules also change from time to time. 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 does Medicare 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 1-800-633-4227, or visit the Web site at http://www.medicare.gov.