Why didn't Medicare cover my ambulance bill?

Unfortunately, Medicare does not always cover ambulance charges to the hospital. It is important to remember that Medicare is a benefit, not an insurance plan. Medicare determines whether an ambulance trip is medically necessary by an established set of guidelines. If it is deemed not medically necessary by these guidelines Medicare will not cover the ambulance trip. Many factors contribute to this decision by Medicare. Some of these factors include: 

•Did the patient’s condition at the time 911 was called warrant immediate medical attention? Remember, this decision is made by Medicare, not by the EMS staff attending to the patient. 

•Could the patient have been taken to the hospital by any other means of transportation other than an ambulance? 

•If the patient was being transferred from one hospital to another hospital by ambulance, could the patient receive the same level of care from the transferring hospital? Also, in many cases Medicare will not pay for transport from a greater facility to a lesser facility, which includes being transported from a hospital back to a residence.

Show All Answers

1. Why do I have to pay for a public service like EMS? Don't I already pay taxes for that?
2. Why didn't Medicare cover my ambulance bill?
3. What do I do if Medicare does not pay my ambulance bill?
4. Why wasn't a claim filed with my secondary insurance company after Medicare denied my claim?
5. The hospital filed with my insurance company, so why didn't Great Bend EMS?