When a patient needs help getting to the hospital or requires transportation for other medical services, they might be concerned about the availability of insurance coverage. When it comes to Medicare, what is and isn’t covered can be confusing, particularly when it comes to ambulance transportation services.
Medicare Coverage for Emergency Ambulance Services
Emergency ambulance services are covered by Medicare Part B, provided the patient meets a list of requirements. According to Medicare, an emergency is considered to be a situation in which the patient’s health is in serious peril, and there is no other safe means of transportation.
Specifically, Medicare lists the eligibility for emergency ambulance services as:
- An ambulance is medically necessary, meaning there are no other safe ways to transport the patient,
- The purpose of the trip is for the patient to receive services covered by Medicare or to return from receiving services,
- The patient is being transported between locations, such as a hospital and care facility, according to Medicare’s guidelines for coverage, and
- The ambulance transportation company meets all of Medicare’s requirements.
Medicare Coverage for Non-Emergency Transportation
Ambulance services generally are not available to patients that simply don’t have access to other transportation. However, Medicare does provide some coverage for non-emergency transportation, provided the patient meets a few requirements.
For non-emergency ambulance services to be covered, a patient must prove that:
- They are confined to a bed, meaning they are unable to walk, get up without help, or sit in a wheelchair or chair, or
- They require vital medical services during transportation that are only available in an ambulance, such as vital function monitoring or the administration of oxygen or other medications.
Even though these non-emergency trips might be covered, some patients will have to jump through a few hoops to ensure payment. For example, those who reside in skilled nursing facilities (SNF) may need to get a written order from a physician for the transportation within 48 hours of the trip.
If the trips will be regularly scheduled, Medicare can also cover them if there is a written order from a physician indicating that the trip is medically necessary and the patient meets Medicare’s other requirements (listed above).
MedTrust Medical Transport Works With Medicare
MedTrust is a mobile healthcare provider that strives to improve patient outcomes. As South Carolina’s fastest-growing company, we serve clients throughout the area as well as patients in North Florida. A majority (80%) of our services are hospital transports, and we work health insurance providers, including Medicare.
Contact us for more information about our services, or joining our team of highly-dedicated EMTs and Paramedics.