A costly bill is the last thing you need to deal with in that situation, so it’s important to have the right insurance policy to protect you. Here’s what you need to know about insurance coverage for ambulance services.
The Cost of an Ambulance Ride
An ambulance ride might not seem like it should be expensive, but you’re paying for a lot more than a fancy Uber ride. For one, the vehicles alone can cost more than $250,000. You may also receive life support, medication, and other medical care from the ambulance personnel while on the move. Although the cost can vary significantly, you’ll usually end up paying somewhere between a few hundred to several thousand dollars for an ambulance ride. Your actual bill depends on factors such as the following:
Location: Ambulances may be more expensive in some areas of the country than in others. Trip distance: Ambulance services often include a per-mile charge. If you receive transportation to a facility that’s farther away, you’ll pay more. Transport type: If you take an air ambulance, your costs will be much higher, likely in the tens of thousands. Treatment on the trip: You’ll pay for any medical care you receive in the ambulance, including the cost of any medicine or drugs used.
For example, in California, the average cost of ambulance transport is $589. In Irving, Texas, a resident under the age of 65 would pay $750 for basic life support, the cost plus a 30% markup of all consumables used, $15 per mile, and a $5 technology fee.
Car Insurance Coverage for Ambulance Rides
Auto insurance is usually your best option when your ambulance trip is due to a car accident. Unlike with health insurance, you won’t have to pay a deductible or copay. In fact, your car insurance may cover your deductible or copay for your health policy if you need to use both. You can get coverage for health-care costs due to a car accident through medical payments coverage or personal injury protection (PIP). They’re optional in most states, so don’t assume you already have them. Both can pay for your and your passengers’ ambulance services if you’re in an accident. They also can help you if a car hits you as a pedestrian. However, there are some limitations. Most important, auto insurance only covers ambulance services when they’re “medically necessary.”
Health Insurance Coverage for Ambulance Rides
If you need ambulance services for something other than a car accident, you’ll need health insurance to get coverage. Private health insurance, Medicare, and Medicaid all cover ambulance services to varying degrees. Here’s how it works for each of these.
Private Health Insurance
Private health insurance generally covers medically necessary ambulance rides. However, unlike with auto insurance, you often still have to pay something out of pocket. At the very least, you’ll have to meet your deductible before your policy helps with your bill. Even then, you may be on the hook for a copay or coinsurance, which would mean you’d have to pay an additional flat fee or a portion of the costs above your deductible. As you review those documents, check for other restrictions on your policy’s coverage. For example, insurance policies usually only cover transportation to the nearest hospital that can provide appropriate services. That means you might pay more of the bill if your ambulance takes you to the second-closest hospital. Even if your policy covers ambulance services and you take a medically necessary trip, you may face surprise bills if your ambulance company is out of network. It can be hard to avoid this issue because you rarely have time to check whether an ambulance provider is in or out of your insurance network in an emergency. In fact, roughly 71% of ambulance rides trigger out-of-network charges, resulting in a median bill of $450.
Medicare and Medicaid
To get coverage for an emergency ambulance ride through Medicare, you must have Medicare Part B. It covers medically necessary transportation to the nearest appropriate medical facility that can give you the care you need. You’ll be responsible for your deductible and 20% of the costs. Medicaid also covers medically necessary ambulance rides from state-licensed providers, although some states have copays and limitations on services. Fortunately, they’re usually insignificant. For example, in Kansas, there is a $3 copay per trip. Check the rules in your state before riding in an ambulance to avoid any surprises.
Getting Your Ambulance Bill Covered
To get coverage for an ambulance bill, confirm you have the right insurance in advance. Consider adding medical payments coverage or PIP to your auto policy because with them, you won’t be charged a deductible or copay for medical bills. There’s not much you can do during an emergency to keep costs down, but if you’re taking an ambulance as part of a non-emergency situation, ask the provider whether they’re in your network. If not, try to secure a different ambulance or alternative transportation. If you’ve already taken an ambulance ride and your insurance doesn’t want to cover it, check the laws in your state for protections against surprise medical bills. Some have restrictions on ground ambulance charges in emergencies. Even if yours doesn’t, try to negotiate. Reach out to your insurer and ambulance company, get someone on the phone, and see what they can do to help you. If you’ve already completed your trip and received a bill for ambulance services because the company was out-of-network, check your state laws for protections against surprise billing. Whether or not there are such rules, still try to negotiate with your insurer and ambulance company.
