Problem:

Mr. D recently returned home after being hospitalized with a number of severe medical conditions, including end-stage renal disease. Mr. D requires dialysis three times a week. His family contacted a local ambulance company to request regular appointments for transportation to the dialysis facility, because he is confined to his bed. The family also forwarded a letter from Mr. D’s doctor stating that this transportation was medically necessary because Mr. D needs medical services during your trip that are only available in an ambulance. However, the ambulance company refused to transport Mr. D because it said that Medicare would not pay.

What To Do:

Mr. D’s family called its local State Health Insurance Assistance Program (SHIP). A counselor informed them that Medicare covers non-emergency transportation to a dialysis facility when a doctor or other health care professional certifies that the ambulance transport is necessary because of the patient’s medical condition. The SHIP counselor mailed a copy of the relevant regulations to the ambulance company. The company agreed to transport Mr. D to his regular appointments.

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