Does Insurance Cover Ambulance Rides? Everything You Need to Know
10 Minutes
Team Curative
Apr 11, 2022
In the United States, healthcare services can be expensive without insurance, and ambulance rides are no exception. Which may make you wonder, “Does insurance cover ambulance rides?”
The answer is: sometimes. Whether or not you receive coverage for ambulance rides depends on the type and scope of your insurance plan(s) in particular. This page details everything you need to know about the relationship between ambulances and insurance so that you can rest easy knowing you’re covered in worst-case scenarios.
While you’re being proactive about understanding which health insurance services you’re covered for, be sure to work with a trustworthy health insurance company that puts a priority on transparent billing and plan management. With a digital-first approach to healthcare, you can do everything you need to do in a couple of clicks, without wasting time or needing to sift through the fine print.
Find in this article:
Which types of insurance cover ambulance rides?
When does insurance not cover an ambulance ride?
How much is an ambulance ride without insurance?
Can I choose the ambulance company I want to use?
Which types of insurance cover ambulance rides?
When does insurance not cover an ambulance ride?
How are ambulance fees calculated?
How much is an ambulance ride without insurance?
How much is an ambulance ride with insurance?
What to do when you get an ambulance bill?
What is accident insurance?
Which insurance companies cover ambulance rides?
What do you do if an ambulance company is not in your insurance network?
Can I choose the ambulance company I want to use?
Summary
Which Types of Insurance Cover Ambulance Rides?
Insurance is usually fairly straightforward. For example, if you want LASIK, some vision insurance may provide coverage. If you want to visit a chiropractor, health insurance likely provides coverage.
Ambulances are a little different. A couple of different types of insurance have the potential to cover your ambulance bills.
Does auto insurance cover ambulance rides?
Auto insurance covers ambulance rides if three criteria are met.
You are calling an ambulance because you are injured due to being involved in a car accident. In other words, your ambulance ride is directly related to your car insurance policy.
You have purchased insurance that provides for ambulance service, such as personal injury protection (PIP), medical payments coverage, or uninsured or underinsured motorist coverage.
The ambulance ride is deemed medically necessary. Your insurance contract will spell out what qualifies as a medical necessity in your contract. For example, feeling neck or back pain, or suffering a more severe injury like a broken bone, will almost always qualify.
Does Health Insurance Cover Ambulance Rides?
Health plans generally cover ambulance rides, subject to copays, deductibles, and coinsurance which depend on the plan.
With health insurance, you usually need to hit your annual deductible before you are eligible for ambulance coverage. A deductible is a fixed dollar amount that you agree to when you enroll in a new health insurance plan. For example, if your deductible is $2,000, your ambulance ride ends up costing $1,500, and you have not contributed anything to your yearly deductible so far, you could end up receiving no coverage at all for your ambulance ride.
Even after you hit your deductible, you may be responsible for paying a copay or coinsurance. A copay is a flat fee associated with certain healthcare services—in this case, an ambulance ride. For example, your copay may be $100 or $200 for an ambulance ride. Coinsurance refers to when you and the insurance company split the bill on a percentage basis. For example, your coinsurance rate may be 80% (paid by your insurance company) and 20% (paid by you, out of pocket).
Although health insurance coverage is usually less comprehensive for ambulance services, it does come in handy for individuals who do not purchase PIP on their car insurance plans, but are then involved in car accidents and need to make use of ambulance services. Overall, the answer to “Does health insurance cover ambulance rides?” is: it depends.
Does Public Health Insurance Cover Ambulance Rides?
Public health insurance refers to a health insurance policy that is sourced from or with the assistance of a state or federal government program. Two popular public health insurance plans are Medicare and Medicaid.
Does Medicare Cover Ambulance Expenses?
Medicare is a health insurance program managed by the federal government that also offers affordable healthcare plans mostly to individuals who are 65 years of age and older.
Medicare is divided into four parts: A, B, C, and D. You are usually covered for ambulance services if you are enrolled in Medicare part B, which deals with a variety of outpatient healthcare services.
Medicare part B closely resembles private health insurance insofar as it requires you to manage things like deductibles, copays, etc.
Does Medicaid Cover Ambulance Rides?
Medicaid is another popular public health insurance plan offered primarily to individuals who may not be able to afford private health insurance plans.
Medicaid covers ambulance services so long as the ambulance company is fully licensed by the state it is operating in.
Outside of emergencies, Medicaid covers ambulance services with a statement by a doctor that the service is required.
When Does Insurance Not Cover an Ambulance Ride?
Under a health plan, an ambulance ride will likely not be covered if it's not medically necessary. Whether an ambulance ride is covered under auto insurance depends on whether coverage providing for ambulance was purchased, such as PIP, medical payment, or uninsured or underinsured motorist coverage.
How Are Ambulance Fees Calculated?
Some medical services, such as physical examinations, are billed on a flat-rate basis, meaning you pay a fixed amount for the full service. In the case of ambulance rides, the cost is variable rather than fixed, meaning your ambulance ride could end up being affordable—or quite expensive.
In general, ambulances typically charge based primarily on the number of loaded miles during your trip. A loaded mile counts as a mile where you are being transported by the ambulance—miles incurred on the way to pick you up are usually not counted towards your total. For example, if the cost per loaded mile was $100, and you were transported 10.5 miles, your ambulance fee would be $1,050.
Ambulance companies sometimes also charge for health services, such as providing oxygen. Overall, ambulance fees have increased substantially in the past five years, and billing practices are not standard throughout the industry.¹
How Much Is an Ambulance Ride Without Insurance?
The prices ambulance companies set are not regulated by the government, which means if they’re not fixed due to an agreement with an insurance company, charges can add up quickly. Without insurance, you’ll always be on the hook for the full bill.
A recent study by a University of Michigan team in the May 2020 issue of the journal Health Affairs estimated that ambulance rides without insurance can cost up to $20,000.²
How Much Is an Ambulance Ride With Insurance?
If you're wondering how much an ambulance costs with insurance, it can vary depending on your specific health plan and location. With auto insurance the entire bill may be covered depending on the coverage under your policy.
Under a health plan, you are likely covered for ambulance service but will owe copays, deductibles, and coinsurance up to an out-of-pocket maximum for the year. Hopefully, we were able to answer your question "How much does an ambulance cost with insurance?"
What to Do When You Get an Ambulance Bill?
Most of the time, ambulance bills will be sent to your insurance company directly, and you will receive documentation from your insurance company rather than the ambulance company itself.
In the case that you were unable to provide your insurance information to the ambulance company, you may receive an ambulance bill in the mail. If this happens to you, contact your insurance company for clarification on how to proceed, as different companies in different states may handle the process differently than others.
If you don’t have insurance and you receive an ambulance bill, there are a few ways you can potentially reduce the bill to make it easier to pay.
Ask for an itemized version of the bill to ensure you aren’t getting overcharged for any services.
Haggle with the ambulance company if you notice certain services are billed higher than expected. For an understanding of general ambulance costs, see the above section titled “How much is an ambulance ride without insurance?”.
If a long period of time has gone by without paying the bill, you may be able to settle with the ambulance company for a lesser amount, either with your own negotiation skills or with the help of a qualified lawyer.
What Is Accident Insurance?
Accident insurance is exactly what it sounds like—insurance that covers you in the case of an accident. An accident can be anything from an unexpected fall to a broken bone.
Accident insurance can help pay for ambulance costs when you find yourself in a situation where you need to use an out-of-network ambulance, or you simply do not have ambulance coverage in the first place. Accident insurance typically pays you a lump sum directly rather than working with ambulance companies to settle the bill.
Accident insurance is an excellent supplementary insurance policy to have alongside a more general health insurance policy if you are an individual who is at high risk of certain accidents that will require ambulance transportation.
Which Insurance Companies Cover Ambulance Rides?
The vast majority of both car and health insurance companies will offer plans that cover ambulance rides.
When it comes to ambulance rides, rather than focusing on your insurance company, focus on how to pick the right health insurance plan. Be sure you have adequate coverage for ambulance rides if you think there is a chance you will need one in the upcoming year so that you can avoid unwanted billing surprises.
Summary
Does insurance cover ambulance rides? Most of the time, the answer is yes, but it depends on the exact situation and the type and scope of your insurance policies.
When selecting a health insurance company for more general ambulance transportation coverage, be sure to work with a trustworthy company that makes it clear what you are and aren’t covered for. Understanding your health insurance plan completely, without needing to sift through the fine print, gives you the best chance of reducing medical expenses in worst-case situations when ambulance transportation is required.
The content on this blog is not medical advice. Patients experiencing a medical emergency or who have concerns about their medical situation should call 911 or their primary care provider (or the local emergency number) immediately.
References
Reed, T. (2022, February 22). Ambulance rides are getting a lot more expensive. Axios. Retrieved November 7, 2022, from https://www.axios.com/ambulance-rides-are-getting-a-lot-more-expensive-cee897fe-63b7-4412-aa67-718109773e79.html
Sky-high surprise bills from air ambulance flights possible for many patients. Institute for Healthcare Policy & Innovation. (n.d.). Retrieved November 7, 2022, from https://ihpi.umich.edu/news/sky-high-surprise-bills-air-ambulance-flights-possible-many-patients
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