Does Medicare cover air ambulance?

A serious injury or illness might require the need for an ambulance service. If the ambulance must travel a long distance or over rough terrain, you might require an air ambulance. In this case, you might ask, does Medicare cover air ambulance? Learn more to determine if your air ambulance trip will be covered.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Jan 26, 2021

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The Highlights

  • Air ambulance is for the most extreme emergencies.
  • Medicare requires doctor recommendation and approval.
  • There are limitations to how an air ambulance can be used.

A serious illness or injury could require the need for an ambulance service. If the trip to the hospital is long or difficult, emergency personnel might recommend an air ambulance.

This can result in questions regarding your Medicare cost and coverage and whether you have to pay for Medicare when you turn 65 and beyond.

As you might expect, an air ambulance is more expensive than one on the ground. With something this expensive, does Medicare cover air ambulance? This could be a crucial factor in determining your overall health insurance coverage.

To ensure you’re getting affordable health insurance, enter your zip code to compare competitive health insurance rates.

What is Medicare?

Medicare is a federal health insurance program for those 65 or older, younger people with a disability, or those with end-stage renal disease. Millions of people enroll in Medicare to help pay for doctor’s visits, treatments, and medication.

Knowing if there are copays for doctors visits with Medicare is incredibly important so make sure to research what the copay is for different types of Medicare.

There are three parts of Medicare; Part A (hospital insurance), Part B (medical insurance), and Part D (prescription drug coverage). Part A covers inpatient hospital stays and care in a nursing facility.

Part B covers doctor’s services, outpatient care, and medical supplies. Part D covers prescription drugs, which includes shots and vaccines.

The Medicare Advantage Plan is an option for those looking for advanced coverage, such as an air ambulance. This plan combines Part A, Part B, and Part D into an all-inclusive plan through a third-party provider.

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What is an air ambulance?

Most ambulances are ground vehicles that carry patients to a medical facility during an emergency. However, some situations require travel through the air. This might be because time is of the essence, they have to travel a long distance, or must get past rough terrain.

An air ambulance is a specially outfitted helicopter or fixed-wing aircraft. It allows the emergency personnel to complete the same tasks they would in a ground ambulance but to reach the medical facility quicker and easier.

Does medicare cover air ambulance?

Whether or not Medicare will cover an air ambulance depends on the program in which you’re enrolled. Part A, Part B, and the Medicare Advantage Plan all feature ground ambulance coverage.

However, Medicare highly favors ground transportation as it’s a much less expensive option.

Part B and the Medicare Advantage Plan will provide air travel coverage if certain criteria are met. This includes air transportation being necessary, a doctor’s recommendation, and the receipt of approval from Medicare.

How does air ambulance transportation work?

In order for Medicare to pay a portion of your air ambulance travel, you must receive pre-approval. If a doctor determines that your life is in the balance, Medicare might waive the pre-approval requirement. Otherwise, there are certain steps that must be taken.

Before you can be transported by air, a doctor must recommend that this type of transportation is medically necessary. They then must contact Medicare and request approval.

If approved, Medicare will provide partial coverage, with the patient being responsible for a percentage and the deductible.

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What does medically necessary mean?

The most important factor in being approved for an air ambulance is that it must be medically necessary. This means that you must require an immediate and rapid ambulance transportation that cannot be provided by ground.

The most common reason why air transportation is required is when the nearest hospital lacks the equipment or trained staff for a necessary surgery. The patient will then be airlifted to the nearest hospital with the ability to perform such a procedure.

What are the limitations of Medicare covering air ambulance?

While Medicare might approve the use of an air ambulance, there are certain limitations to know. Medicare will only approve the air ambulance taking you to the nearest hospital that can perform the procedure.

Even if a further facility will provide better treatment, the ambulance must take you to the nearest hospital.

Before approving the use of an air ambulance, Medicare will often require that there is a risk of death. If the patient is not in imminent danger without the procedure, they will require ground transportation to the nearest acceptable hospital.

Frequently Asked Questions

1. Will Medicare approve an air ambulance if a doctor requests it?

Medicare won’t approve an air ambulance just because a doctor requests it. They must determine if this type of travel is absolutely necessary before approval will be given.

2. How much will I pay for ambulance service?

If you require ambulance transportation, you pay 20% of the Medicare-approved amount. This might be more than if you buy health insurance.

3. What is Advance Beneficiary Notice of Non-Coverage?

The ambulance service is required to provide you with an Advance Beneficiary Notice of Non-Coverage if it’s a non-emergency and they believe Medicare might not cover the transportation.

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Does Medicare cover air ambulance: The Bottom Line

Medicare might cover air ambulance transportation if you have Plan B or the Medicare Advantage Plan. It depends on how life-threatening the situation is and where the nearest qualified hospital is located.

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