If you have Medicare, you need to know what you are covered for. Here is everything to know about Medicare and ambulance service coverage.
Have you ever had to travel in an ambulance? Did you know that 35.2 percent of adults over the age of 64 need ambulance transport to the emergency room each year? Ambulances are also used for non-emergency transportation as well.
Do you wonder about Medicare and ambulance service coverage? Keep reading to learn the answer to this question.
Different Ambulance Services
Most people know that ambulances take people to the hospital during emergency situations. They also take patients from long-term care facilities to appointments or for tests.
Ambulances are commonly staffed with paramedics or emergency medical technicians (EMTs). They travel by ground or air.
Coverage with Medicare
“Original Medicare”, Medicare Part A and B, is a federal health insurance program. It’s available for U.S. citizens and legal residents over 64 years. Younger people with disabilities and those with end-stage renal disease can also qualify.
Each year, Medicare enrollees must meet a deductible. They also pay a 20 percent co-pay for Medicare-approved services.
Medicare Part A covers inpatient hospitalizations. It also pays for skilled nursing facilities (SNF) and hospice care. Part A covers some home health care services as well.
Medicare Part B covers specific physician services, outpatient care, and preventive services. It also pays for medical supplies.
If you want prescription medication coverage, you need Medicare Part D. This is a separate Medicare-approved plan that you must buy.
Insurance Plan Options
Since Medicare doesn’t cover all medical expenses, many people buy extra insurance. Medigap is supplemental insurance that covers the gaps in Original Medicare.
Medicare only pays for 80 percent of major medical costs. Medigap coverage includes deductibles, co-pays, coinsurance, blood, and foreign travel.
Medicare and Ambulance Coverage
Medicare Part B will cover emergency ambulance services. In some cases, they also pay for non-emergency ambulance transportation and services.
Eligible emergency ambulance services include the following situations:
- It’s the only medically safe way for your transport
- Transport to and from a facility for Medicare-covered services
- Transport to and from specific locations according to Medicare guidelines
The ambulance company must meet Medicare requirements.
Non-emergency ambulance services require that the patient is bedridden and unable to walk or sit. Or, if the patient needs medication administration or monitoring of vital functions during transport.
Medicare may cover scheduled trips with a prior written order from your doctor. If Part A pays for your care in an SNF, most ambulance services are paid by the SNF.
Covered by Life Flight
Life Flight is a private plan that members pay an enrollment fee for participation. This provides air transportation in the event of a medical emergency. This plan also offers ground transportation by participating companies.
Medicare Part B will not pay for the cost of membership or other fees. Yet, Part B will pay for medically necessary air transport. This means you require immediate, rapid transportation that can’t be provided via ground ambulance.’
Any part not covered by Part B is billed to Life Flight if you’re a member.
Are You Looking for Answers About Medicare?
Most people have questions about the many parts of Medicare coverage. This article answered the question about Medicare and ambulance coverage.
Senior Affairs is your source for information about Original Medicare and Medicare Gap programs. We’re not an insurance provider or agency. Thus, we can’t answer specific questions about claims, eligibility, or payment.