Medicare coverage for ambulance transport

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  #1  
Old 02-18-2022, 06:53 PM
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Default Medicare coverage for ambulance transport

“I had a fall accident at our house, severe enough I could not get up, hit my head and shoulder, wife and neighbors could not get me up. They made the decision to call 911, EMTs arrived in 2-3 minutes, ambulance about 10 minutes later. Here is the kicker, to get coverage for the ambulance trip ($500) it must be medically required as determined by a doctor (or apparently in this case) by the ambulance personnel, they did not do this, I get to pay. Also, they never mentioned I could go by our own car, once I was off the floor.

I am sending this out as a warning, apparently IF you can go by your own car, do not take the ambulance, you will probably be charged. At least ask the question if the ambulance will be medically qualified, then make your decision, I just learned the hard way.”

BTW, I am doing very well with physical therapy, and I am almost back to normal (so beware!!).
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Old 02-18-2022, 07:15 PM
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Nucky Nucky is offline
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I'm sorry about your slip and fall. This same kind of thing happened to me in November of 2020. 911 sent a few very helpful people out who advised me that the hospital was super busy and that taking my own car was probably the best route for me medically because there was a waiting list for the ambulances and they thought I would have to pay the full charge. My wife ended up driving me. I can see the hospital from my house.

I think the best advice I could give to anyone who reads this post is Prevent, Prevent, Prevent, the fall. It was an accident and it was a life-changing event. Old comfortable shoes are the main culprit combined with a little spritz of rain.

Feel better VT. You are one of my favorite posters and have helped me so many times. I wish I could do something for you now. I'm still a little jammed up myself.
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Old 02-18-2022, 09:00 PM
Stu from NYC Stu from NYC is offline
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Thanks for sharing

Wish you a quick and full recovery
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Old 02-18-2022, 11:04 PM
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Sure am sorry to hear of your accident. Glad it did not keep you from posting your helpful informative posts here. Sending wishes for your continued improvement.
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Old 02-18-2022, 11:09 PM
davem4616 davem4616 is offline
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sorry about your mishap...thanks for the tip...you always add value when you respond to a post, or post

I guess the good news is that you are okay, albeit $500 wiser

funny how money doesn't seem to matter when a loved one is in trouble and we need help....we're not 29 anymore

thank you for sharing
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Old 02-19-2022, 06:25 AM
Babubhat Babubhat is offline
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Same issue here but I was able to get them to pay. Take your car if not life threatening. Get well soon
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Old 02-20-2022, 05:54 AM
rduval rduval is offline
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Thank you for this information. Best wishes for a fast recovery.
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Old 02-20-2022, 06:15 AM
tsmall22204 tsmall22204 is offline
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Never thought of that. When I had my heart attack in 2020, I was not charged for the ride.
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Old 02-20-2022, 07:05 AM
elevatorman elevatorman is offline
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Some supplement plans will pick up the cost. Now may be the time to find out if your plan does. Before it is needed.
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Old 02-20-2022, 07:09 AM
thevillages2013 thevillages2013 is offline
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Quote:
Originally Posted by villagetinker View Post
“I had a fall accident at our house, severe enough I could not get up, hit my head and shoulder, wife and neighbors could not get me up. They made the decision to call 911, EMTs arrived in 2-3 minutes, ambulance about 10 minutes later. Here is the kicker, to get coverage for the ambulance trip ($500) it must be medically required as determined by a doctor (or apparently in this case) by the ambulance personnel, they did not do this, I get to pay. Also, they never mentioned I could go by our own car, once I was off the floor.

I am sending this out as a warning, apparently IF you can go by your own car, do not take the ambulance, you will probably be charged. At least ask the question if the ambulance will be medically qualified, then make your decision, I just learned the hard way.”

BTW, I am doing very well with physical therapy, and I am almost back to normal (so beware!!).
Thanks for the heads up and glad you are getting over the accident. Just curious were you on a ladder ?
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Old 02-20-2022, 07:49 AM
DaleDivine DaleDivine is offline
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Quote:
Originally Posted by villagetinker View Post
“I had a fall accident at our house, severe enough I could not get up, hit my head and shoulder, wife and neighbors could not get me up. They made the decision to call 911, EMTs arrived in 2-3 minutes, ambulance about 10 minutes later. Here is the kicker, to get coverage for the ambulance trip ($500) it must be medically required as determined by a doctor (or apparently in this case) by the ambulance personnel, they did not do this, I get to pay. Also, they never mentioned I could go by our own car, once I was off the floor.

I am sending this out as a warning, apparently IF you can go by your own car, do not take the ambulance, you will probably be charged. At least ask the question if the ambulance will be medically qualified, then make your decision, I just learned the hard way.”

BTW, I am doing very well with physical therapy, and I am almost back to normal (so beware!!).
Sorry about your accident David and glad you're doing better.
My wife was having some issues breathing and I called 911. EMTs came then ambulance. Took her to TV hospital. They took her right in and got her in an ER room. If she hadn't gone by ambulance she would have had to wait in the waiting room with other people. I had to pay a partial of the ambulance trip but worth it to get her in the ER ASAP. Soooo, bottom line is, I guess it depends on the circumstances.
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Old 02-20-2022, 07:58 AM
Jantao Jantao is offline
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Quote:
Originally Posted by villagetinker View Post
“I had a fall accident at our house, severe enough I could not get up, hit my head and shoulder, wife and neighbors could not get me up. They made the decision to call 911, EMTs arrived in 2-3 minutes, ambulance about 10 minutes later. Here is the kicker, to get coverage for the ambulance trip ($500) it must be medically required as determined by a doctor (or apparently in this case) by the ambulance personnel, they did not do this, I get to pay. Also, they never mentioned I could go by our own car, once I was off the floor.

I am sending this out as a warning, apparently IF you can go by your own car, do not take the ambulance, you will probably be charged. At least ask the question if the ambulance will be medically qualified, then make your decision, I just learned the hard way.”

BTW, I am doing very well with physical therapy, and I am almost back to normal (so beware!!).
Sorry to hear about your fall!. Glad you are recovering. It was a good idea to have the EMT professionals lift you up off the floor. Well meaning family and friends can hurt you if not done properly.
  #13  
Old 02-20-2022, 08:06 AM
fireman fireman is offline
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Should be covered!!!

I was the Fire Chief in a different state and we had our own transporting ambulances.(around 12,000 EMS calls a year)

This is a paperwork/billing issue that was not done right by the ambulance service. If they did not tell you that you can take yourself and don’t medically need to go by ambulance, then it’s their responsibility to check the right boxes that were sent to your insurance/Medicare.

Note in my opinion having a fall that hit your head and can’t get up is medically needed and should be covered.

You should call the ambulance service and have them correct it and resubmit the claim.

This is one reason our community wanted to keep the ambulance service under the fire department and not to a private service.

FYI replying on my phone, so please excuse any misspellings or bad grammar

Last edited by fireman; 02-20-2022 at 08:24 AM.
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Old 02-20-2022, 08:08 AM
Marine1974 Marine1974 is offline
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Glad your on the mend . Ambulance service back up north is now $1700 . It was paid by my insurance. Generally ambulances get you in the ER faster than walk ins . Thanks for posting .
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Old 02-20-2022, 08:31 AM
dp.reed dp.reed is offline
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I'm sorry to hear of your accident and wish you a full recovery.

As always, your advice and wisdom are the best.
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