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does medicare cover ambulance services in florida

Does Medicare cover ambulance services in Florida?

If you’re struggling to understand Medicare in Florida, Connie can help. Ask Connie your question, and a local, licensed agent will help you navigate your Medicare journey. Complete this form to have your question answered. It could be featured on Dear Connie.

Dear Connie,

My friend told me they received an enormous bill after being transported to the hospital. I don’t know how I would survive being hit with this bill. How can they do this to seniors?

So, I’m wondering, does Medicare cover ambulance services in Florida? And how can I protect myself from high out-of-pocket costs in case I need emergency care?

In case of an emergency,
William from Miami Beach, Florida

Find the right Medicare plan for you

Dear William,

This is a great question, and we’re happy you asked us. I’ll do my best to break down Medicare coverage and how you can protect yourself should you need an ambulance or emergency air transportation.

First, yes, Original Medicare Part B does cover ambulance transportation. However, there are requirements. Coverage is only given if traveling in another vehicle could endanger your health, and it’s medically necessary to receive care from a hospital, critical access hospital, or a skilled nursing facility.

For example, Medicare may cover emergency ambulance services if you’re in shock, unconscious, bleeding heavily, or need skilled medical treatment during transportation. These are just some examples.

Agent tip:

“Original Medicare Part B covers a portion of ambulatory services, but you’re responsible for the Part B deductible and 20% coinsurance. Because Original Medicare doesn’t have an out-of-pocket maximum, expenses can add up.“

Original Medicare Part B will also cover emergency airplane or helicopter transportation if your health requires immediate or rapid transportation that ground ambulance transportation can not provide. One of these requirements must apply:

  • Your pickup location can not be easily reached by ambulance ground transportation.
  • Obstacles, like heavy traffic, or long distances, could prevent you from getting care quickly by ground ambulance.

Of course, if you need emergency ambulance ground or air transportation, that’s not something that can be foreseen or planned. Just as your friend experienced, emergencies can often come with surprise medical bills.

On average, a ground ambulance ride costs $1,200 without insurance. And air ambulance transportation can cost, on average, $38,000.

If you meet the qualifications, Medicare Part B will cover some of these services. You would be required to pay the Medicare Part B deductible plus 20% of the Medicare-approved amount.

For example, if the average cost of emergency ambulance transportation is $1,200, you would be responsible for the Part B deductible and $240 out-of-pocket. In the case of the air ambulance ride, you would pay the Part B deductible and $7,600 out-of-pocket.

Unfortunately, Original Medicare has no cap on its out-of-pocket costs, and we’re not yet including the emergency care you need – only the transportation. That is why many people enroll in a Medicare Supplement (Medigap) or Medicare Advantage plan.

A Medicare Supplement plan can help cover the cost of some or all of the out-of-pocket expenses not covered by Medicare – that 20% coinsurance.

A Medicare Advantage plan offers you a maximum out-of-pocket to shield you from unexpected expenses, provides the same level of coverage as Original Medicare, and frequently offers extra benefits that other plans don’t offer. These extra benefits can include dental, vision, hearing, non-emergency medical ground transportation, and more.

So, if you’re looking to protect yourself from unexpected costs from Medicare or an ambulance company, I recommend that you explore Medicare Supplement and Medicare Advantage plans. One of these types of plans should give you the coverage you need and that’s right for your budget. They’ll also provide that peace of mind it sounds like you’re looking for.

A local licensed agent can help you determine if a Medicare Supplement or Medicare Advantage plan is right for you. Call (623) 223-8884 (TTY: 711) to speak with a Connie Health agent.

At Connie Health, we help you throughout your Medicare journey. If you have any additional coverage questions, please feel free to reach out. We’d be happy to help.

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Read more by William Revuelta

I am a Spanish-speaking Florida Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2009. I’m an avid sports fan and enjoy watching international soccer matches and college football. When not with my family, I listen to podcasts ranging from history to sports talk.

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