Does Medicare pay for ambulance rides?

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Does Medicare pay for ambulance rides?

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My 83 yo sister fell and hit her forehead requiring 50 stitches to close resulting injury. Her husband is unable to drive at night. Would Medicare have paid for the ambulance?

Emergency Care Medicare Paying for Care

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Yes, if they have Part B.

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yes, might have to pay the 20% co-insurance

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Yes, partially. Supplemental will help as well. For us, it brings the price down from $2500 to $250.

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Just a thought--if the situation isn't particularly urgent and there's no excessive bleeding, would a taxi be a suitable option? I don't know if there is a medical service that's simpler (and less expensive) than an ambulance, the latter being "overkill" (no pun intended) in many cases.

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For 90% of my relatives, there are no taxis (or Uber) available in their area. And a fall - particularly if there is blow to the head that is bleeding- in an elderly person is certainly urgent.

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Medicare paid for Luz to be transported by ambulance three times and tricare picked up the balance.

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For that Medicare would have paid. Hitting her head was serious. They do not pay for just transporting unless it can be proven that is the only way to get the person to a dr.

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In my experience, Medicare will pay to take someone to the Emergency Room. But, Medicare will not pay to take someone home from the ER. Hospitals sometimes have contracts with local ambulance companies to give people going home from the ER an ambulance ride at a reduced rate. So, going to the ER is covered by Medicare (in my experience). Coming home from the ER cost $160. Without it being a special hospital rate, coming home would have been over $1,000. Be prepared to pay the ambulance company driving you home. They typically demand my credit card before tendering service.

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Its probably a USA question, but here in Australia if you have a healthcare card or pension card it's free. When I wasn't on a pension & was working I used to pay Ambulance Australia yearly fee of $58 but that was 16years ago. But that yearly fee covered me for unlimited trips in ambulance and ambulance transport home if I needed (no one to take care of me or drive me home) it also covered transport from one hospital to another.

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Yes as this was a true emergency. You may have to pay the 20% Medicare won’t cover or your deductible first (if you have one). She had a pretty severe laceration. I don’t think you will have an issue as she needed the ambulance transportation & it was medically justified.

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Yes...Most insurances.

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Medicare would pay to the hospital but not back to the house.

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Medicare will cover a return ambulance trip back to the house for medical necessity reasons.

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We have a company called Medride in Oklahoma. It can transfer to and from hospitals, doctors etc. so when my dad left the hospital ER and in patient stays, that is who we used. Also as transportation to his doctor. Reasonable but not cheap.

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It depends on the Medicare plan. When I had to go to the hospital by ambulance, my co-pay was $250! On Medicare HMO!

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Yes, if she has a Medicare Supplement, it will pay everything. I had to go by by ambulance twice to the hospital and Medicare and my supplement paid. I didn’t pay anything. Look at her Medicare Supplement.

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They do ask for your insurance cards. I showed them my Medicare card and Supplement card and all was good. They don’y Take you back home though.

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If you are not medically safe to get home, day via a taxi, because of weakness, dizziness, no one brought your wheelchair or Walker,
You can't get from a vehicle to entry door..and to apartment inside the building...then doctor can approve ambulance back home. This happened several times to LO last year after TIAs were misdiagnosed. LO should have been in hospital IMO but CT was clear so they discharged person who could not walk in the middle of the night.

Also many hospitals give a voucher for taxi home...but you have to ask and make it clear you don't have a way to pay for a cab.
or even a blizzard and taxi won't come to hospital,

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If one can afford the cost, our town emergency squad has an annual fee you pay each January - $500.00. They will take you to and from the two local hospitals. For all others, the first two times in a year there is no charge. After that they send a bill for you to pay or submit to your insurance. Sometimes if it’s a discharge trip home, you may have to wait if there are emergency calls going on.

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Last time I checked, Medicare and Supplemental Health did NOT pay for ambulances.

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For medical emergencies yes they will pay for it. https://www.medicare.gov/coverage/ambulance-services

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If at any time a person falls with head injury, DO NOT attempt to get them up. You need to rule out head or neck fracture with a CT scan which requires 911. You also have to rule out a brain bleed which may result from a fall that the head is impacted. You tell the 911 your loved one fell and her head is bleeding and afraid to get her up. I would imagine that would constitute a medical emergency. But I'm not a doctor or anything so what do I know, right?

"Ambulance services
Medicare Part B (Medical Insurance) covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services, and transportation in any other vehicle could endanger your health. Medicare may pay for emergency ambulance transportation in an airplane or helicopter to a hospital if you need immediate and rapid ambulance transportation that ground transportation can’t provide."
https://www.medicare.gov/coverage/ambulance-services

Please note my 89 year old mom with end-stage Alzheimer's had a bad UTI leaving her unable to walk, Medicare initially refused to pay it. I think it was the way the ambulance drivers charted it and never stated she was unable to stand or walk, and severely lethargic. I filed six months worth of appeals they finally approved it. I mean I must have sent at least 25 to 30 letters and appeals. Yes six months later they finally approved it. Wow. Even when the Emergency Room doctor wrote the diagnosis that her condition was a threat to her life -- WHICH IT WAS. Symptomatic UTI to the point she was unable to stand..

She had another episode of UTI and she got septic from that. Only through the Grace of God she survived that, and efficient medical care.

If at any time you have to fight for payment, please do so. DO NOT IGNORE ANY KIND OF DENIED CLAIM. Look at your Medicare statement VERY carefully.

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I would also check and see if their fire insurance, not sure what it is called, we don't live in the city so our house is covered by contract with rural fire and that includes medical transportation, however, they don't advertise the fact. We didn't know for 20 years that the 600.00 annually wasn't just for the fire department in case we had a fire.

It is worth checking into all of your insurance policies, homeowners etc to find out if they have any extras.

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Medicare will cover ambulance services, if they are medically necessary. If in doubt, make sure that the paramedic puts down a diagnosis that Medicare will pay for.

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I fell late one summer evening (10 pm) while taking a 30 minute walk in a well-lit, safe area. Have no idea why I fell, as was just feet from going up the steps to my back door, as I was finishing up the 30 minutes. I’m now 70 and haven’t fallen since.

I was bleeding from my nose and possibly head - where I came down hard on a concrete walkway. No one nearby to help. I had my cellphone with me and not knowing whether I’d soon pass out, called 911. I’d been on Medicare for 3 months and knew an ambulance would be covered and my supplement plan F would pay the remainder. Medicare only pays for transport to closest hospital that can care for one’s particular injuries or needs - if you want a hospital further away that you personally prefer, they’ll not take you there if one closer can adequately treat you.

i ended up with a broken nose and elbow. Six months earlier I’d signed on with an inexpensive group accident insurance policy, thinking now that I was 65 I might well need it. They reimbursed me $4K for the surgery, ambulance, x-rays, ER, anesthesia, etc.

In short, know your benefits and complete the paperwork when necessary for reimbursement! In an emergency, Medicare pays for an ambulance. Supplemental Medicare policy should pay the rest, unless you’ve got a policy that has a deductible.

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Agreed..being responsible for oneself or family is a PERSONAL responsibility.No one wants to pay for anything if they don't have to. but these are life events. I warned my friends who want to skip buying insurance that cover what Part B does not, they believe the medicare that covered 80% is enough, but that part B 20% can add up fast!! A $10,000 emergency of any kind is STILL $2000 out of pocket, and many don't read the Medicare guide that shows ONLY the hospital room is covered, AFTER deductible too. Part B is EVERYTHING else- bandages, the MD, X-rays, special treatments..ALL of it is part B. I took the Blue Shield plan F which is high deductible...I pay $55 month. do ~$670 a year. If I wanted a very low deductible I pay $200+ a month--so $2500 for CERTAIN each year, plus the deductible! If you are ill or believe you need many MD visits then choose what is best cost $$ for you.

There is NO reason a person can't pay for a cab ride home, or ask a friend or family member. The government is NOT supposed to pay for everything in our lives, and medical is part of that. A lazy 55 yr old man I knew let his mom call an ambulance to go to the hosp for an MRI..it was too much bother for him, the state pays the cost, which means all the taxpayers support his laziness. She also could have called a taxi, but did not, the cost is $20-$30 MAX to the hospital, so why is this such a burden?

Even if you save $10.to pay a neighbor of his gas/time in an emergency that is at least planing ahead, as we should.

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Another thing that needs checking into is if someone rides in ambulance with the person like a spouse what the fee is. My in laws 94 & 84 husband had to go to hospital & wife rode in ambulance it was an additional $ 800.00 just for her to ride along.

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That’s crazy. I’ve ridden in an ambulance with my mother, it didn’t cost any extra.

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It pays some, but not all.

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Around here if you call 911 and they come they attempt to bill whatever insurance you have to make $$ (for the city service of 911) but if I understand it correctly they don't hold you for the remainder if you don't have it...but I need to double check on that. They don't talk about it much for fear people will not call...

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If it is substance abuse, they will not pay. I had an elderly client who was going through DTs because he was drinking himself to death after his wife's death. The bill was $700 in 1997. They did not pay for ambulance but did pay on the hospital stay.

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So sad. More people need to know about this exception... especially since DTs occur from withdrawal... lack of alcohol.

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Medicare pays for an ambulance to transport in an emergency. It depends on if there is additional insurance if there is and how much of a deductible. If advance life support is provided with the ambulance that charge is often separate and not covered.

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Advance Life Support is covered by Medicare in an medical emergency.

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I just call Medicare and ask when I have a question. They are available 24/7 on their 800 line.

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I've found that the times my 96 yr old mom who is in a assisted care has had to go to the ER for emergency care there has been no problem with them paying for it.

"Emergency care refers to emergency medical attention given to an individual who needs it. It includes those medical services required for the immediate diagnosis and treatment of medical conditions which, if not immediately diagnosed and treated, could lead to serious physical or mental disability or death."

IMO - "could lead to serious physical or mental disability or death." For any person other than a physician... I would suggest calling for an ambulance every time because you are not qualified to make a determination of someones medical condition or "need of care". Medicare should not refuse payment. They never have with my mother.

So, my answer to... "My 83 yo sister fell and hit her forehead requiring 50 stitches to close resulting injury. Her husband is unable to drive at night. Would Medicare have paid for the ambulance?"... is yes, they would have paid for it.

But, you need to be aware that getting your sister back to home (or to the assisted care in my mom's case) is on the patients shoulders. Even when they cannot walk or have other disabilities that prevent them from getting back on their own. That would be very difficult to get them to pay for.

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I had to pay for my moms ambulance when she fell in assisted living.

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Her skull was crushed and bleeding, thought that would be covered, but it wasn't. Her head swelled up horribly.

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There's a law on the books in Kentucky (unless they changed it) but as of 2015, when you use a public ambulance, they cannot charge you. The law states that any service entity (such as police, fire, ambulance) who takes tax-payer monies for their budget cannot also charge individuals. When I called to get the bill back to a zero balance the ambulance services would say they HAVE to bill or wouldn't be able to live off what the government gives them. When I addressed this with the County Attorney, the bills were reduced to a zero balance. If they bill you (illegally) and ruin your credit, you can sue for $40-50,000 for an unjustified ruined credit. The County Attorney knew this, too, and took care of the bill.

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