Medicare and Medical Transportation

In another article, we saw the things that Medicare will cover some Medical costs under parts A and B. However, you may still be left with questions, and one such question may be “Does Medicare cover medical transportation?” I’m glad you asked, because this is exactly the question that this article aims to address.

In terms of ambulance services, Medicare Part B (that is, your Medical Insurance) covers emergency ground ambulance transportation when the need arises to be transported to a hospital, critical access hospital (CAH), or skilled nursing facility (SNF). It also helps to pay for the transportation if you’ve had a sudden medical emergency that leaves your health in serious danger from being unable to be transported by other means (such as a car or taxi).

It’s also possible that Medicare will cover emergency ambulance transportation via airplane or helicopter if your condition requires immediate and quick transportation that going by ground cannot provide. However, one of the following must apply:

  • Your pickup location can’t be easily reached by ground transport
  • Long distances or other obstacles (such as heavy traffic) could prevent you from getting care quickly if you traveled by ground ambulance.

Additionally, Medicare will only pay for transport to the nearest medical facility that’s able to give you the appropriate care.

In special circumstances, you might be able to receive limited, medically necessary non-emergency ambulance transportation if one of the following situations applies:

  • Such transportation is necessary to get treatment or diagnose your health condition
  • The use of any other method of transport could be dangerous to your health
  • You have a written order from your doctor which states that transportation via ambulance is necessary due to your medical condition

If you’re concerned you might not be eligible for such service, fear not—all people that have Medicare Part B are covered.

As to how much it’s going to cost you in Original Medicare, you’ll pay 20% of the Medicare-approved amount, and the Part B deductible applies. Also, any and all ambulance suppliers must accept assignment. However, Medicare’s payment might be different if you get transported by a CAH, or by an entity that’s both owned and operated by a CAH.

Another thing to be aware of is that if you choose to go to a facility further away, Medicare’s payment amount will be based on the charge to the closest appropriate facility. However, if there are no local facilities that are able to give you the care you need, they will then pay for transportation to the nearest facility outside of your area that can give you the necessary care.

As always, there are many more things to be aware of, but this article was meant to cover a few of the basics. To get more information, you can research on your own or discuss any questions or concerns you might have with your doctor or other health care provider.