Medicare offers you coverage when you get treatment, such as when you’re in the hospital or at an outpatient appointment. That coverage can extend to the pharmacy if you get Part D or a Medicare Advantage plan with drug coverage included.
But what about the emergency ride to the hospital? Yes, Medicare can cover you in that instance, too.
Which part of Medicare pays for this?
While ambulance services bring you straight to the hospital where you receive inpatient treatment, Part A isn’t the Medicare Part responsible for covering you here. Part B helps pay for it.
Medicare Part B is what takes care of you outside the inpatient setting. In 2021, its deductible is $203 and it has a $148.50 monthly premium. You can sign up for it when you’re first eligible, but you can also sign up for it during the General Enrollment Period from January 1 to March 31 if you haven’t already.
Its coverage works like this – once you get your service, Medicare will settle an amount with the medical professionals. Then, Medicare pays 80% of that, leaving 20% of the Medicare-approved amount.
What forms of transport does Medicare cover?
Many refer to this coverage as strictly for ambulance rides. But there are other modes of transportation in case ground transport is unavailable. Medicare also covers helicopters and airplanes in an instance like this.
This coverage is not limited to hospitals. Other emergency centers such as skilled nursing facilities and critical access hospitals apply here as well.
When are ambulance services NOT covered?
Medicare Part B only covers emergencies (with few exceptions). If you are getting ambulance services in a non-emergency situation, then Medicare won’t cover you. You will have to cover the costs, which the ambulance service providers will inform you of when you get an Advance Beneficiary Notice of Noncoverage.
One of the exceptions for Medicare covering you when getting ambulance transport for non-emergency care is if you have a note from your doctor stating that this is medically necessary. This is the case for those who have serious medical conditions such as End-Stage Renal Disease.
Your coverage is important
The last thing you should be thinking about is how much you will pay out-of-pocket when you’re on your way to getting emergency treatment. For more information about how Medicare can save you on ambulance services, call us today at 830-217-6711.