Transportation costs are something to think about as you get older. You need to travel to and from hospitals, doctor’s offices, and various treatment centers. If you’re over 65, you are probably enrolled in Medicare Part A or Part B, which can help offset the rising price of various medical treatments. But what about transportation to the treatments? Medicare will occasionally help with transportation, too, though usually not for routine health care.
In a non-emergency situation, be sure to check with the ambulance provider to ensure that they participate in Medicare’s program. The federal government’s healthcare plan can provide for non-emergency ambulance transportation if you need diagnosis or treatment in order to avoid endangering your health. One example is that Medicare may cover transportation via ambulance to and from a dialysis facility if you have End-Stage Renal Disease. As with most Medicare services, you’ll need a written order from your doctor to verify that ambulance transportation is medically necessary due to your health condition.
If the ambulance company believes that Medicare will not reimburse you for transportation services rendered in a non-emergency situation, the company must give you an Advance Beneficiary Notice of Noncoverage.
Medicare Part B coverage
Medicare Part B covers ambulance services to or from a hospital, critical access hospital, or skilled nursing facility. Medicare covers ambulance services only when other transportation services could endanger your health. Medicare will only cover ambulance service to the nearest appropriate medical facility that is able to provide the care you need. Medicare coverage also depends on the severity of your condition. Medicare can cover emergency ambulance transportation for conditions such as:
- in shock
- bleeding heavily
- needing skilled medical treatment during transportation
In some cases, Medicare may cover air transportation if your health condition requires rapid ambulance transportation beyond that which is provided by ground-based services. If your pickup location is remote and can not be reached by ground ambulance, you may qualify for air transport coverage. You may also be covered if long distances or obstacles like heavy traffic would prevent you from receiving medical services in a timely manner.
When it comes to costs, you’ll normally pay 20% of the Medicare-approved amount for transportation services. This is after you’ve also paid the Part B deductible. If you choose to be transported to a facility other than the closest one, Medicare’s coverage will be based on the closest facility. This means that you will be responsible for paying any additional fees incurred during transportation to a different facility out of your own pocket.