Does Health Insurance Cover Ambulance Costs?
How much is an ambulance ride? The cost of an ambulance might not be the first thing you think about in an emergency, but it's a good idea to understand how much you'll likely pay for an ambulance in case you need one. While your insurance might help cover part of the costs, you'll likely have some out-of-pocket expenses.
According to GoodRx, an ambulance ride costs around $1,300 without insurance. The cost can vary significantly, depending on where you live. You may also pay more based on whether the ambulance is operated by the government or a private company. Your costs can increase based on how far you need to be transported, as many ambulances charge mileage. If the paramedics use medications or other life-saving procedures, you'll also be charged for those things.
You typically pay for the full amount if you don't have insurance coverage for ambulance rides. Insurance companies often negotiate the rates for a lower total cost, but uninsured individuals don't get those negotiated rates. You can ask for a discount if you don't have health insurance. You might also be able to set up a payment plan with the provider to spread out the costs of an ambulance ride.
Private health insurance typically covers an ambulance ride if it's medically necessary, and it generally only covers a ride to the closest hospital that can give you the care you need. You might have to reach your deductible before the insurance policy covers ambulance expenses, or you could have a copay or coinsurance amount that you have to pay. Some ambulance providers will be out-of-network for your health insurance, which means you'll likely pay even more.
The amount you pay if you have insurance coverage varies significantly, depending on your plan. Insurance companies typically negotiate the ambulance costs down to about $750 from the full $1,300 average. You may pay some or all of that amount based on your coverage. For example, if you've already met your deductible for the year, you might only have to pay a copay or coinsurance amount. Review your health insurance coverage now, so you know what to expect if you need an ambulance.
If you need an ambulance due to a car accident, your car insurance might provide coverage. This typically falls under your medical payments coverage or personal injury protection coverage. You don't usually have to pay a deductible, copayment or coinsurance if you go through your car insurance. Contact your auto insurance company to see if you have ambulance coverage if you're in a car accident. Like health insurance, car insurance coverage typically only applies if the ride is medically necessary.
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Medicare and Medicaid both provide some coverage for ambulance rides. Medicare covers an ambulance ride if it's medically necessary under Medicare Part B. You can expect to pay your deductible, plus 20% of the charges that are approved by Medicare under your Medicare coverage. The deductible amount can change yearly. For 2023, the deductible under Medicare Part B is $226.
Medicaid costs can vary, depending on where you live. Each state runs its Medicaid program, so the amount you're responsible for can vary based on your state's guidelines. Your state might also have specific requirements for what qualifies as a medically necessary ride in an ambulance.
If you have a medical emergency, taking an ambulance could save your life or improve the outcome by getting you the medical care you need faster. Never skip the ambulance if you truly need it. However, make sure it's a medically necessary situation to increase the chances of insurance covering the costs. Being taken to the closest hospital that can handle your situation can keep your costs lower.
After the emergency situation, contact your insurance company if they don't initially cover the ride. They might review the situation and change their decision. You can often make payments on your portion of the bill if it's more than you can afford.
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