Medicare coverage of ambulance transportation is usually limited if it’s not an emergency situation.
Medicare may cover non-emergency ambulance trips if:
They’re medically necessary
You’re taken to or from certain places
The ambulance company meets Medicare requirements
In this instance, transportation is medically necessary if:
You’re confined to a bed, or
If you aren’t bed-confined, you need vital medical services during the trip that you can only get in an ambulance; and
The reason for the trip is to get a service or return from a service you need that Medicare covers
Medicare only covers transportation to and from certain places in your service area that can give you the care you need. Your service area is the geographical region around a facility that serves most of the people in your town. You can call 800-MEDICARE to get a list of facilities in your service area.
A trip from your home to a dialysis facility might be covered. Click here for a list of places Medicare might cover ambulance transportation to and from.
If you need regular ambulance trips to and from a dialysis facility, your doctor should send the ambulance company a written order ahead of time saying your health requires ambulance transportation.
When Medicare covers non-emergency ambulance trips, it’s covered under Part B. As for most Part B-covered services, Medicare pays 80 percent of the cost. You or your supplemental insurance must pay the remaining 20%. Medicare suppliers must accept Medicare’s approved amount for the service as payment in full.
Medicare never pays for ambulette trips. An ambulette is a wheelchair-accessible van that provides non-emergency transportation for people with disabilities.