Am I Covered ?
There's no simple answer to this question. The short explanation is, probably, but it depends.
Most health insurance plans cover most of the cost of ambulance transport. We've prepared the following guidelines below to help you determine if your trip is protected whether you are a Medicare recipient or the beneficiary of a commercial insurance plan.
Medicare covers 80% of the cost of ambulance transport, provided that it has been deemed necessary by a medical professional.
Determinations for medical necessity include any medical emergency or situation that would appear to a layperson to be a medical emergency, transport a non-ambulatory patient, cannot sit safely in a wheelchair and requires a transfer in a stretcher.
Clients can find more information about reimbursement by visiting the Centers for Medicare and Medicaid Coverage Determination Web Page.
For Commercial Insurance
Reimbursement for ambulance transports covered by commercial insurance providers will depend mainly on the specifics of your plan.
Like any other insured service, ambulance transports will be subject to the deductible in your plan.
Most insurance providers typically reimburse Heart to Heart for a large percentage of the cost of the ambulance transport (this is mainly determined by the specifics of the plan and the premiums paid by the insured). The remainder is the patient's responsibility.
Suppose you anticipate requiring the services of a private ambulance firm and are unclear about whether or not insurance will cover your transport. In that case, you should call your insurance provider directly and ask them.
If you have questions about why you are receiving a bill from Heart to Heart, please feel free to contact our billing department.