Is an air ambulance covered by Medicare?

The last thing you want to worry about in a medical emergency is cost. However, the situation may have called for an air ambulance to transport you to the hospital, and you may worry about the associated expenditure. In this situation, can you claim for an air ambulance on Medicare? 

Yes, Medicare will cover ambulance rides as long as it is medically necessary or otherwise ordered by your doctor. This guide covers when Medicare Part B covers ambulance rides and how much it will cost you have you meet your deductibles.

Does Medicare pay for air ambulance services?

Medicare will cover up to 80% of the cost of your transportation by air ambulance so long as it is medically necessary. You will need to have the correct type of Medicare coverage in place and ensure that this form of transportation was recommended by a recognized professional. You should also be aware of specific state and federal laws that are in place to protect your rights in these situations.

Does Medicare cover helicopter transport?

Medicare may pay part of the bill if you need emergency ambulance transportation by plane or helicopter. A doctor or qualified individual on the scene must confirm that you may be at increased risk if they transport you by road instead.

Medicare typically pays 80% of covered fees once you have reached your deductible.

Does Medicare Part A cover ambulance transportation?

When it comes to Medicare coverage for an ambulance, this will fall under Part B. You must have Part B coverage in place before you can claim for air or ground ambulance transportation.

Medicare Part B will cover ambulance transportation by road when traveling in any other vehicle might endanger your health. In addition, if your condition requires medically necessary services from a skilled nursing facility, critical access hospital, or regular hospital, the insurance will pay for it.

Medicare Part A will typically cover in-patient care, hospice, nursing homes, skilled nursing facilities, and similar costs.

Are all ambulance rides covered by Medicare?

Medicare will also pay for non-emergency ambulance transportation when it is deemed medically necessary and you have a written order from a doctor. This may be the case if you have a chronic disease that requires medically-essential ambulance transport on a regular basis or when alternative modes of transportation may not be available.

Note that Medicare will only pay for air ambulance services when you are transported to the nearest medical facility to provide you with the necessary care.

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What are the average costs of Air Ambulance Transportation?

According to the US Government Accountability Office, the median price for any air ambulance transportation was around $36,400 in 2017. Even if Medicare pays for 80% of the bill once you have met your deductible, you may still have to cover some potentially significant costs.

In this case, a flexible spending account (FSA) may help to prepare for such costs. This tax-free savings account builds money you can apply to medical costs, over and above those covered by a health insurance plan.

Regulators have also introduced specific laws that may help protect you regarding unexpected medical bills. For example, the No Surprises law regulates the fees you receive from out-of-network air ambulance providers. This law protects people who receive coverage from Medicare. In this situation, you cannot receive any surprise bills, especially if you receive the service out of network and without prior authorization.

The Air Ambulance Affordability Act of 2019 insists that air transportation service providers inform people about the costs to understand them before they agree to go ahead.

The Affordable Care Act aims to make health care affordable for everyone. As part of this, insurance companies must invest at least 80% of the revenue they collect from insurance accounts.  This may help lower Medicare costs in general.

Air Ambulances and Medicare Coverage: The Bottom Line

Medicare Part B will pay up to 80% of the cost of air ambulance transportation if a medical professional insists it is necessary. In certain situations, Medicare may also pay for this type of transportation if it is not an emergency, such as the need for regular treatment for a chronic disease.

Certain laws are in place that may protect you from surprise costs associated with this transportation, and you can use an FSA to help pay for any additional medical costs.

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