Transport from a short-term or acute care facility to the closest long-term acute care facility.Transport to the closest in-network hospital that provides necessary medical care if the original hospital you were taken to cannot provide adequate care.Transport from an out-of-network hospital to the closest in-network hospital when medical services are required.Plans may also cover non-emergency transports, including: Health insurance plans normally cover emergency transport to the nearest medical facility that can treat your condition. “Difficulty breathing, chest pain or other life-threatening conditions that require assistance by a paramedic before arriving at the hospital will most likely be covered.” “The best way to think about medical necessity is if you need care even before you get to the hospital,” says Perry. “Whether an insurance company will cover an ambulance ride depends on whether the transport was medically necessary or not.” For example, you may pay 20% for services and the health plan picks up the other 80%. The exact coinsurance percentage varies by health insurance plan. Coinsurance is the percentage of a health insurance bill that you pay after reaching your deductible. “Whether an insurance company will cover an ambulance ride depends on whether the transport was medically necessary or not,” says Ken Perry, an emergency medicine doctor in Charleston, South Carolina.Įven if an ambulance ride is deemed medically necessary, such as following a serious car accident, you may still have to pay a copay, coinsurance and a deductible, says Perry.Ī health insurance deductible is the amount you pay out of pocket before your health insurance company pays a portion of your health care expenses. Most private health insurance plans cover medically necessary ambulance transport. Private health insurance companies typically provide at least some coverage for ambulance rides, but it depends on the reason for the transport. On Healthcare Marketplace's Website Does Insurance Cover Ambulance Rides?
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