Insurance does typically cover ambulance transportation as long as it's for a justifiable emergency. However, even in those cases, a single insurance plan rarely pays the entire bill. The patient portion depends on factors such as the deductible on the Medicare or private health insurance plan and the hospital choice.
Impacting the Payment
Medicare will generally pay 80 percent of the ambulance bill for recipients who have met their Part B deductible. The patient could pay more if he insists on going somewhere other than the closest hospital, or uses an ambulance to change facilities for non-emergency reasons. Patients with private health insurance typically pay a co-pay of $15 to $100, or coinsurance of 10 to 50 percent for ambulance service.
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Necessary Expenses Only
Insurance companies do scrutinize every claim for whether it's medically necessary, and that includes ambulance rides. Investigators will check to see if the patient was bleeding, in shock, unconsciousness or needed oxygen or skilled treatment during the ride to the hospital. If that report says none of that was necessary, the insurer can choose not to cover any of the ride. People do have the option to carry ambulance coverage in supplemental insurance. In case the primary doesn't cover the whole ride, the supplemental can.