Age Spots, by Jackie Dover
We all hope to never be in a situation where we need ambulance transportation. Needing an ambulance means there is an emergency and we need help quickly.
Medicare does cover ambulance transportation if it meets certain criteria:
- When transportation in any other vehicle could endanger your health
- You need medically necessary services
- The ambulance company meets Medicare criteria
- Transportation will be to the nearest facility that can provide the care needed
For any Medicare service, it is important to review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) carefully to detect errors or potential fraud and abuse. If you have recently been transported by ambulance look over your MSN to verify:
- You were not billed more miles than the actual distance of transport
- You were not billed for emergency transportation if there was no emergency
- The appropriate service was billed (basic life support vs. advanced life support)
Be aware that Medicare will deny the claim if:
- You could have safely been transported by a wheelchair van or another vehicle
- You were transported in an unapproved vehicle, like a taxi or transit bus
- Your ambulance did not have two emergency medical technicians (EMTs)
- You were taken to a non-covered destination such as your doctor’s office, independent labs, clinics, etc.
The Missouri Senior Medicare Patrol (SMP) has a mission to empower and assist Medicare beneficiaries and their caregivers to prevent, detect and report healthcare fraud, errors and abuse. You can do this by being careful and protecting your Medicare and personal information. If you suspect there may have been errors, fraud or abuse relating to ambulance transportation or any Medicare service, call the Missouri SMP at 1-888-515-6565.
If you are a senior that needs assistance, please call Aging Matters 800-392-8771, because Aging Matters.