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!!:a040:).

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.

Thanks for sharing

Wish you a quick and full recovery

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.

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

Same issue here but I was able to get them to pay. Take your car if not life threatening. Get well soon

Thank you for this information. Best wishes for a fast recovery.

Never thought of that. When I had my heart attack in 2020, I was not charged for the ride.

Some supplement plans will pick up the cost. Now may be the time to find out if your plan does. Before it is needed.

Thanks for the heads up and glad you are getting over the accident. Just curious were you on a ladder ?

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.
:pray::pray:

Ambulance Charge
 

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. :)

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

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 .

I'm sorry to hear of your accident and wish you a full recovery.

As always, your advice and wisdom are the best.

Appeal the charge
 

Years ago my mom was in assisted living and throwing up. 911 was called transport and MC denied. I appealed it and it got paid. Worth a try especially since you couldn’t get up.

Thank you for sharing finally a thread that actually has some merit!!!

No ladder, I slipped getting out of the hot tub, using the plastic steps, and fell on the concrete pad, I now have really nice wooden steps with a railing.

After years of CPR/AED classes, one very important thing I learned is that if you aren’t sure if you should call 911, CALL 911! You never have to take the ride and it won’t cost you if you don’t. Let the first responders decide if it is unsafe to take a car.

Another important thing is that if the problem is serious, don’t take a car if there is an ambulance available unless there is an extra person to watch the patient while in transit.

I had to fight for 3 months with ambulance service to get it right.

VT, get well soon, I have always appreciated your offers for help, and your abilities in tinkering. . .


hmmm. . . . from the injured person's point of view, $500 for priority service to ER for an unknown injury incident, might want to go and then dispute the charges later. . also, pictures, pictures, pictures of situation for claim support. .

Memories of Natasha Richardson or Bob Saget might come to mind with what appears to lay people as simple injuries which can be life threatening. . with a head injury, I might consider the money well spent. .

Thanks for the advice. All the best for a full recovery.

Appeal
 

Search how to file an appeal and do so. It worked for me. However, I also learned the lesson you pass along now.

Appreciate the info, get better soon

Call: Dispatch health 352-415-0991
Medicare pays. It is a emergency number who will come out & help. They are like a 911 coming out to help. After they evaluate the situation whether you should have to go to the emergency room. Medical pays all costs because it saves from everyone being taken to ER when it can be taken care of at home.
You can check them out on:
dispatch health.com

Feel better.

its time for a volunteer ambulance for the Villages.What are we paying the ad valorem for Fire

Good deal glad you are doing well. I know you are a hands on guy so the ladder was my best guess. The hot tub tackled you but it will also help you through the aches and pains

although true, if this is a medical emergency which requires immediate medical attention, such as a stroke, you are losing valuable time in deciding that you need immediate medical attention.

The defualt should be call the ambulance and transport if any doubt about seriousness. Then refile and argue the charges with the ambulance company.

In my humble(and former EMT) opinion, a transport was probably warranted. Some of the major factors involved in the decision, is not just whether the patient is ambulatory, but also the incident and cause. Incident being the what(fall, general malaise, etc), and how severe(concussion, etc)? Cause, being the tricky one?! Many times we just don't know(at the scene) whether the patient just lost their footing, or some underlying condition caused or contributed to it? That's where it could get dicey, as that condition could worsen, and that could be a liability, if the ambulance service refers you to personal transport? Good luck, Tinker, in your appeals.

All good points, in hindsight, and after a few phone calls, it appears that once I was up and in the chair (by the EMTs) that I could have used my own transportation and it was the opinion of ambulance or EMTs? that the ambulance transportation was not necessary. SO I have filed this under lessons learned, and I hope these posts help others in the future.

As for me, I am doing well, hope to try bowling this week, just one game, and gradually get back to league play.

Once again, thank you to all for your suggestions and your well wishes. VT

Glad you are ok! I enjoy your knowledge and responsible answers !