happyjack Asked July 2019
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?
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About 18 months later my mom had lab work, ordered by her doctor. WE got charged over $1,000. This time I had a long conversation with Medicare. This individual was very helpful and told me that usually when patients are denied coverage by Medicare it's because someone coded the bill/invoice incorrectly. He told me that it was my mom's doctor's office who coded the lab invoice incorrectly. He told me to take it back to them and to ask them to redo it, that I had talked to Medicare who had advised that it was miscoded, and to resubmit it Medicare.
So, I then told the Medicare representative what had happened 18 months earlier with the ambulance bill. Again, he said that someone at the ambulance/paramedics office got lazy (his word) and coded it wrong. He said next time call them tell them we were denied and ask them to correct and resubmit the bill to Medicare. I hope this helps.
Where do they bill the homeless people. ??
Medicare and my insurance if it's medically necessary....meaning you can't ride in a car.. ...if you are admitted to hospital...you don't pay....if you are sent home you pay $300.
Medicare covers ambulance trips when the trips are medically necessary.
People reading these posts be careful because there are some misleading information here.
"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.
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.
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.
It is worth checking into all of your insurance policies, homeowners etc to find out if they have any extras.
"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.