Q:

Does insurance pay the cost of ambulance transport?

A:

Quick Answer

Whether insured through Medicare or private insurance, the cost of ambulance transport is potentially covered, however, the ambulance transportation must be deemed medically necessary, explains the Los Angeles Times. Even when deemed medically necessary, the amount covered will depend on the individual's insurance plan and any co-pays or deductibles that must be paid first. Medicare, for example covers 80 percent, while the patient pays 20 percent of the approved amount after the patient has met their annual deductible, states Medicare.gov.

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Full Answer

The reason for the ambulance ride and the distance of the ambulance transportation are critical in determining if it is medically necessary. In most cases, medical necessity is defined as a circumstance in which the patient is unconscious, bleeding heavily, in shock or needs the medical attention of a professional while en route to the hospital, according to Medicare.gov.

Though many insurance companies will cover transportation to the nearest medical facility, coverage for relocation to specialized facilities for more concentrated medical care may also be covered based upon medical necessity. If possible, a patient should inquire about the coverage of relocation before agreeing to the transportation, notes the Los Angeles Times.

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