Medicare typically covers 80% of the Medicare-approved amount for ambulance services. This includes emergency and certain nonemergency services for serious health conditions.

Medicare pays 80% of the Medicare-approved cost for emergency and certain nonemergency services after you have met any deductibles your plan requires.

If your ambulance company charges you more than this amount, you may incur additional charges. However, most ambulance companies accept the Medicare-approved amount.

If you haven’t met your annual Medicare deductible, you’ll have to pay that first, although the Medicare deductible isn’t specifically for ambulance services.

Read on to learn more about Medicare coverage for ambulance and other emergency transportation services.

When to call an ambulance

Time is of the essence when a medical emergency takes place. Call 911 for an ambulance if:

  • you can’t move the person who is ill or injured
  • moving them might cause further harm or damage
  • you can’t get them to a hospital or medical facility quickly
  • the person’s condition appears to be life threatening, including such symptoms as:
    • trouble breathing
    • profuse or uncontrollable bleeding
    • extreme pain
    • signs of a heart attack or stroke
    • mental confusion
    • suicidal thoughts or threats

Medicare will only cover the cost of your ambulance if transportation in a nonemergency vehicle, such as a car or taxi, would endanger your health.

Medicare typically covers 80% of the cost of transportation to the nearest appropriate medical facility to you.

If you wish to go to a facility farther away, you may incur additional charges. However, if there is a medical necessity requiring that you go to a facility outside your local area, Medicare will usually pay for that service.

For nonemergency situations

If you have a condition that requires regular, nonemergency transportation in an ambulance, you may need an order from your doctor indicating why you need this service for Medicare to pay.

There may be a limit on the number of ambulance rides that Medicare will cover per week or per month for nonemergency transportation.

In some instances, you may need prior authorization and approval, either from you or from the ambulance company, before Medicare will pay. These requirements vary from state to state.

Learn about Medicare nonemergency transportation rules in your state

To learn the specific rules for nonemergency ambulance transportation requirements in your state, call 800-MEDICARE (800-633-4227). If you’re hearing or speech impaired and use a TTY device, call 877-486-2048.

Advance Beneficiary Notice of Non-Coverage (ABN) form

In a nonemergency situation, your ambulance company may provide you with a form called an Advance Beneficiary Notice of Non-Coverage (ABN) so it can charge you if it thinks Medicare may not pay for your transportation. It’s up to you to decide if you wish to sign the ABN.

If you sign an ABN and incur charges that Medicare won’t cover, you’ll be responsible for paying for that ambulance ride. If you don’t sign the ABN, the ambulance company may decide not to transport you.

Your signature on an ABN is never required in an emergency. Ambulance companies may bill you for services even if they don’t give you or you don’t sign an ABN.

If you require emergency medical treatment and can’t be transported to an appropriate medical facility via ground transportation, Medicare may cover 80% of the Medicare-approved cost of an air ambulance service. Air ambulances may be helicopters or fixed-wing aircraft, such as airplanes.

Private membership programs, such as Life Flight, require an annual membership fee not covered by Medicare.

If you participate in a program that offers coverage of air ambulance transportation, it may cover the portion of the cost that’s not paid for through Medicare. Some of these programs also cover the cost of ambulatory ground transportation that is not covered by Medicare.

These programs may be beneficial if you live in a remote, rural area. They may also be helpful if you travel extensively to other countries or locales where appropriate medical care may not be readily accessible.

Situations where an air ambulance is required can include the following:

  • Ground transportation can’t get to you.
  • There’s a significant distance between you and the medical facility you require.
  • There’s an obstacle between you and the medical facility you require.

If you live in a rural area, you may automatically meet the requirements for an air ambulance, provided your doctor signs an order indicating that either time or distance were obstacles to your health.

If you have Original Medicare, Medicare Part B will cover the cost of ambulance services.

If you need medical treatment, including intravenous medications or oxygen during transport, the cost of those treatments will typically, though not always, be included in transport billing and paid for under Medicare Part B.

If you have a Medicare Advantage plan, Medicare Part C will cover the cost of ambulance services and the medical care you require during transport.

Medigap policies are sold by private insurance companies. These policies may cover all or part of the costs of ambulance service that Medicare does not cover.

They may also cover the annual deductible for Medicare Part B. You must have Medicare parts A and B to be eligible for a Medigap policy.

Ambulances were once funded by local taxes, but that’s no longer the case in most areas. Ambulance services can be expensive, especially if you have no insurance.

If you have insurance other than Medicare, your policy will indicate what your out-of-pocket cost will be for an ambulance. This can range from hundreds to thousands of dollars.

If you have Medicare, a combination of factors determines the cost of an ambulance ride. These include a base payment plus mileage and services rendered during transport. These services can include basic life support or advanced life support.

Air ambulance transport costs can be even higher than ground costs, reaching astronomical sums in some instances.

Medicare Part B and Medicare Advantage plans typically cover 80% of emergency ambulance transportation costs after you’ve paid your annual deductible.

If you have a condition that requires nonemergency transportation in an ambulance, Medicare may also pay 80%. However, you may need an order from your doctor indicating why you need this service for Medicare to pay.

There may also be a limit on the number of ambulance rides that Medicare will cover for nonemergency transportation.

Talk with your doctor or Medicare representative to find out the specific rules for nonemergency ambulance transportation requirements in your state.