Your Medicare Coverage
Is my test, item, or service covered?
How often is it covered?
Medicare Part B (Medical Insurance) covers emergency ground ambulance transportation when you need to be transported to a hospital, critical access hospital (CAH), or skilled nursing facility (SNF) for medically necessary services, and transportation in any other vehicle could endanger your health.
Medicare may pay for emergency ambulance transportation in an airplane or helicopter (medevac) to a hospital if you neede immediate and rapid ambulance transportation and:
- Your pickup location is hard to get to by ground transportation, or
- Large distances or other obstacles, like heavy traffic, could stop you from getting care quickly if you traveled by ground ambulance
Medicare will only cover ambulance services (ground or air) to the nearest appropriate medical facility that’s able to give you the care you need.
In some cases, Medicare may pay for limited, medically necessary non-emergency ambulance transportation if you have a written order from your doctor saying that ambulance transportation is medically necessary.
Medicare covers ambulance services to and from your home to the nearest dialysis facility for treatment of End-Stage Renal Disease (ESRD) only if other forms of transportation would be harmful to your health. You may need a note from your doctor.
All people with Medicare are covered.
Your costs in Original Medicare
You pay 20% of the Medicare-approved amount, and the Part B deductible applies. All ambulance suppliers must accept assignment. Medicare's payment may be different if you're transported by a CAH, or by an entity that's owned and operated by a CAH.
If you choose to be transported to a facility farther away than the nearest appropriate medical facility that’s able to give you the care you need, Medicare's payment will be based on the charge to the closest appropriate facility. If no local facilities are able to give you the care you need, Medicare will help pay for transportation to the nearest facility outside your local area.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.