Medicare Coverage for Ambulance Services

What services do ambulances offer?

Ambulance providers offer emergency medical services to people who are injured or seriously ill. Paramedics or emergency medical technologists provide care on the way to the hospital. They are supervised over the radio by emergency room doctors. In addition, ambulances may transport people to and from health care facilities when they cannot travel by other means due to their health.

What is Medicare?

Medicare is:

• a federal health insurance program
• for people over age 65
• for people under age 65 who are disabled in certain ways.

Your local Social Security office can answer your questions about signing up for Medicare and can enroll you in the Medicare program.

Rules about what Medicare does and does not cover can be complicated, and the rules change periodically. The amount of money you are expected to pay for Medicare (Part B) coverage can change every January. The deductibles (what you must pay first before Medicare begins to pay) and the copayments (the percentage of costs you must pay) may also change.

Some people think of Medicare as two health insurance programs: Medicare Part A and Medicare Part B. Each part covers different services. Both parts pay toward costs for services considered necessary for medical reasons.

Medicare Part A (sometimes called "the hospital part of Medicare") pays most of inpatient hospital care and hospice care. Under certain conditions, it pays for up to a couple months of care in a skilled nursing facility. Medicare Part A and Medicare Part B both pay toward home health care if certain conditions are met.

Medicare Part B (sometimes called "the doctor part of Medicare") pays the cost of some medical services, such as doctor visits, and medical supplies.

Does Medicare cover ambulances?

Medicare covers ambulance services under Part B when the care or ride is certified by a doctor as medically necessary and the ambulance company has met the Medicare requirements.

How much do I pay for ambulances services?

Medicare will pay 80% of an ambulance bill that it approves. You pay the remaining 20%. In addition, you must 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.