Paying for an ambulance ride

Have you ever been transported to a health facility by ambulance?

If you have, then you know first hand how expensive they are. For ground transportation the cost can start at $1,000 while air ambulance starts around $15,000. Luckily, Medicare Part B covers ambulance services, but strict guidelines must be followed in order for a claim to be paid.

What are the guidelines for these services? Medicare will cover ambulance services to or from a hospital, critical access hospital, or a skilled nursing facility only when other transportation could endanger your health. Also, the transportation has to be to the nearest facility that can care for you, not a hospital that is farther away or closer to family. The ambulance must be your only way to the hospital or the other covered facilities.

It is up to Medicare to decide whether the claim will be paid depending on your condition.

If Medicare deems your claim eligible for coverage, you will pay 80% after satisfying the yearly deductible. Still, that leaves 20% of your approved amount to pay. If your bill is the minimum $1,000 you will pay $200 and if you have to be taken to a hospital by air ambulance you could be seeing a $3,000 bill. These numbers are averages and depending on your area the price could be higher or lower.

What can you do to protect yourself from these high costs of emergency services?

FireMed is a great alternative. FireMed is not insurance but is a membership program that works with fire departments to provide ambulance services for a fee. FireMed can cover emergency ambulance, non-emergency ambulance (if necessary) and claims services with no further out-of-pocket costs. The FireMed fee is around $60 a year for ground ambulance and approximately $100 for both ground and air transportation, depending on where you live. Along with you being covered personally, your household is also included in the yearly fee.

Ambulance transportation is the number one denied claim in Medicare. A denied claim is often due to paperwork that was not filled out correctly. Claims paperwork is complicated and needs to be filled out completely in order to have your claim paid. Discrepancies on ambulance billing can be difficult to understand and overwhelming.

For people who need help because of denied claims the Senior Health Insurance Benefits Assistance is there to help. SHIBA is a state program that gives unbiased knowledge on Medicare and is there for people who have questions about Medicare including ambulance billing and coverage. You can contact them for assistance at 1-800-722-4134.

It is important to know your coverage when it comes to emergency benefits. Medicare Part B has guidelines that must be followed in order to get a percentage of the bill paid. FireMed has a yearly fee but can often have no other out-of-pocket costs for transportation. Read any FireMed policy carefully and ask questions if the terms are not clear.