Medicare does not cover transportation to and from your doctor’s office, but Medicare Part B may cover emergency ambulance services when other forms of transportation could endanger your health.
Medicare may also cover non-emergency ambulance transportation if you have a written order from your doctor saying that it is medically necessary.
In April 2018, the Centers for Medicare & Medicaid Services (CMS) announced it could be expanding the list of benefits private insurance companies are allowed to cover as part of a Medicare Advantage plan (Medicare Part C). The new expanded benefits could include coverage for transportation to doctor’s offices.
Before taking effect, any benefit packages for 2019 Medicare Advantage plans must first be approved by CMS. The list of approved benefits is expected to be released in the fall of 2018, when annual open enrollment begins.
Medicare only covers non-emergency ambulance services to the nearest medical facility that is able to provide you with appropriate care.
If you go to a facility that is farther away, Medicare’s coverage will be based on the charge to the closest facility, and you must pay the difference.
If the ambulance company thinks that Medicare might not cover your non-emergency ambulance service, they should provide you with an Advance Beneficiary Notice of Noncoverage.
Medicare covers emergency ambulance transportation if you’ve had a sudden medical emergency and your health is in danger.
Medicare may pay for emergency ambulance transportation by helicopter or airplane if your condition requires rapid transportation that cannot be provided on the ground.
Coverage for emergency ambulance transportation depends on the seriousness of your condition.
In some cases, Medicare may cover transportation in an ambulance if you have End-Stage Renal Disease (ESRD) and need ambulance transportation to and from the facility where you receive dialysis treatment.
If your ambulance service is covered by Medicare, Medicare Part B typically covers 80 percent of the Medicare-approved amount, and you pay 20 percent (once your deductible is met).
In 2019, the Medicare Part B deductible is $185 per year.
Medicare Advantage plans provide the same benefits as Medicare Part A and Part B combined into one simple plan. Many Medicare Advantage plans may also offer additional benefits such as coverage for prescription drugs, dental, vision care and – potentially in 2019 – transportation to doctor’s offices.
To learn more about your Medicare Advantage plan options and to compare plans that may be available where you live call a licensed insurance agent atTTY Users: 711 24 hours a day, 7 days a week.
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