Medicare Part B covers emergency ambulance services and, in limited cases, non-emergency ambulance services. Medicare considers an emergency to be any situation when your health is in serious danger and you cannot be transported safely by other means. If your trip is scheduled when your health is not in immediate danger, it is not considered an emergency.
Part B covers emergency ambulance services if:
- An ambulance is medically necessary, meaning it is the only safe way to transport you
- The reason for your trip is to receive a Medicare-covered service or to return from receiving care
- You are transported to and from certain locations, following Medicare’s coverage guidelines
- And, the transportation supplier meets Medicare ambulance requirements
To be eligible for coverage of non-emergency ambulance services, you must:
- Be confined to your bed (unable to get up from bed without help, unable to walk, and unable to sit in a chair or wheelchair)
- Or, need vital medical services during your trip that are only available in an ambulance, such as administration of medications or monitoring of vital functions
Medicare may cover unscheduled or irregular non-emergency trips, but if you live in a skilled nursing facility (SNF), a doctor’s written order may be required within 48 hours after the transport. Medicare may also cover scheduled, regular trips if the ambulance supplier receives a written order from your doctor ahead of time stating that transport is medically necessary.
Medicare never covers ambulette services. An ambulette is a wheelchair-accessible van that provides non-emergency transportation. Medicare also does not cover ambulance transportation just because you lack access to alternative transportation.
Note: If you are receiving SNF care under Part A, most ambulance transportation should be paid for by the SNF. The SNF should not bill Medicare for this service.
Part B covers medically necessary emergency and non-emergency ambulance services at 80% of the Medicare-approved amount. In most cases, you pay a 20% coinsurance after you meet your Part B deductible ($183 in 2018). All ambulance companies that contract with Medicare must be participating providers.