Does Medicare Cover Ambulance Services?

Ambulance services transport you to a medical facility (like a hospital) for care.

Part B covers ground ambulance transportation when traveling in any other vehicle could endanger your health, and you need medically necessary services from one of the following:

• A hospital
• A critical access hospital
• A rural emergency hospital
• A skilled nursing facility

Medicare may pay for emergency ambulance transportation in an airplane or helicopter if you need immediate and rapid transport that ground transportation can’t provide.

Medicare will only cover ambulance services to the nearest appropriate medical facility that’s able to give you the care you need.

The ambulance company must give you an "Advance Beneficiary Notice of Noncoverage (ABN)" when both of these apply:

• You get ambulance services in a non-emergency situation.
• The ambulance company believes that Medicare may not pay for your specific ambulance service.

In some cases, Medicare may pay for medically necessary, non-emergency ambulance transportation if you have a written order from your doctor or other health care provider that says the ambulance transportation is medically necessary. For example, someone with End-Stage Renal Disease (ESRD) may need a medically necessary ambulance transport from their home to and from a dialysis facility.

You may now be affected by a Medicare demonstration program if:

• You get scheduled, non-emergency ambulance transportation for 3 or more round trips in a 10-day period or at least once a week for 3 weeks or more
• You get this transportation from any ambulance company nationwide

Under this demonstration, your ambulance company may send a request for prior authorization to Medicare before your fourth round trip in a 30-day period. They'll do this so you and the company will know earlier in the process if Medicare is likely to cover your services.

If your prior authorization request isn't approved and you continue getting these services, Medicare will deny the claim and the ambulance company may bill you for all charges. Either you or your ambulance company may request prior authorization for these scheduled, non-emergency ambulance services. For more information, call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048.

After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

Medicare may pay for emergency ambulance transportation in an airplane or helicopter if you need immediate and rapid transport that ground transportation can’t provide.

If using other transportation could endanger your health, Medicare will only cover ambulance services to the nearest appropriate medical facility that’s able to give you the care you need.