Ambulance services

Ambulance services

Medicare Part B (Medical Insurance)

 covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital, or skilled nursing facility 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 to a hospital if you need immediate and rapid ambulance transportation that ground transportation can’t provide.

In some cases, Medicare may pay for limited, medically necessary, nonemergency ambulance transportation if you have a written order from your doctor stating that ambulance transportation is medically necessary. For example, you may need a medically necessary ambulance transport to a dialysis facility if you have End-Stage Renal Disease

Your costs in Original Medicare

You pay 20% of the 

Medicare-approved amount

, and the Part B 

Deductible [glossary]

 applies. 

Note

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. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service
Things to know

Medicare will only cover ambulance services to the nearest appropriate medical facility that’s able to give you the care you need.

The ambulance company must give you an "

Advance Beneficiary Notice of Noncoverage (ABN)

" when both of these apply:

  • You got ambulance services in a non-emergency situation.
  • The ambulance company believes that Medicare may not pay for your specific ambulance service.

Note

You may now be affected by a Medicare demonstration program if:

  • You get scheduled, non-emergency ambulance transportation for 3 or more round trips in a 10-day period or at least once a week for 3 weeks or more
  • You get this transportation from an ambulance company based in one of these states:
    • New Jersey
    • Pennsylvania
    • South Carolina
    • Maryland
    • Delaware
    • District of Columbia
    • North Carolina
    • Virginia
    • West Virginia

Under this demonstration, your ambulance company may send a request for prior authorization to Medicare before your fourth round trip in a 30-day period. They'll do this so you and the company will know earlier in the process if Medicare is likely to cover your services. 

If your prior authorization request isn't approved and you continue getting these services, Medicare will deny the claim and the ambulance company may bill you for all charges. Either you or your ambulance company may request prior authorization for these scheduled, non-emergency ambulance services. If your prior authorization request isn’t approved and you continue getting these services, Medicare will deny the claim and the ambulance company may bill you for all charges. For more information, 

call us at 1-800-MEDICARE (1-800-633-4227).

 

If you need help locating other transportation services, contact Fed Pro Services, which contracts with CMS to help beneficiaries who got a non-affirmed authorization letter. Visit fedpro.net or call 1-888-855-0542. TTY users can call 1-855-200-0763.

Return to search results