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Does Medicare Pay for Ambulance Transportation Back to Assisted Living?
Date Updated: July 26, 2024
Written by:
Rachel Lustbader is a writer and editor with a background in healthcare and technology. Her work has been published on websites including HealthCare.com, BiteSizeBio.com, BetterHelp.com, Caring.com, and PayingforSeniorCare.com. She studied health science and public health at Boston University.
Both of Rachel’s grandmothers had very positive experiences in senior living communities, and Rachel saw firsthand the impact that kind, committed caregivers and community managers can have on seniors’ and their family members’ lives. With her work at Caring, Rachel hopes to help other families find communities, caregivers, and at-home products that benefit elderly loved ones and make life less stressful for family caregivers
Medicare doesn’t pay for ambulance transportation back to assisted living. Your Part B plan only covers an ambulance ride to a hospital or skilled nursing facility when you urgently need medically necessary care and traveling in a standard vehicle could damage your health. The ambulance will only take you to the nearest appropriate medical facility. When you’re ready to return to assisted living, you must arrange your own transportation. If you take an ambulance home, you’ll be responsible for the bill for the trip.
What portion of a covered ambulance ride does Medicare pay?
When Medicare covers ambulance transport from assisted living to the hospital, your plan will pay 80% of the approved amount as long as you’ve met your Part B deductible. You’ll be responsible for the other 20% of the ambulance bill. On the way back to assisted living, you must pay 100% of the ambulance bill, so you may want to arrange transportation with a loved one or rideshare service if you can’t drive.
What happens when your ambulance ride isn’t medically necessary?
If you take an ambulance home from assisted living or in another situation that doesn’t qualify as medically necessary, the ambulance company will give you a form called the Advance Beneficiary Notice of Noncoverage. Signing this document shows that you understand that Medicare probably won’t pay for your ambulance ride and that you agree to pay the bill if your plan denies coverage.