Does Insurance Cover Ambulance Rides?

Summary:

A ride in an ambulance could be the most expensive ride of your life ($1,500 on average). If you have car insurance or health insurance, you may be eligible for some assistance in covering part or all of the cost. The key to determining how much coverage you can get is establishing whether or not you meet insurance providers’ criteria. Ultimately, you’ll find your answer when you get your ambulance bill in the mail from your insurance companies.

Unless you’re on a third-grade school field trip to your local hospital, a ride in an ambulance is typically a stressful experience. Once you get past the ambulance ride and any other emergency medical services after that, you’ll have to reconcile the costs. The unfortunate news is that it can get very pricey. If you’ve ridden in an ambulance before, you know. Take that extra pressure off yourself, and keep reading to learn how insurance can help cover the costs.

Does insurance cover ambulance rides?

Seeing that ambulance bill for the first time after an already traumatic event can be frightening. The good news is that you may get help from insurance paying that bill. Does insurance cover ambulance rides? It’s not a simple “yes” or “no” answer but more of an “it depends.”

Your ambulance service coverage depends on the following factors:

  • The type(s) of insurance you have
  • Your insurance company
  • Your insurance policy, including coverage limits, restrictions, and inclusions
  • The nature of and reason for your ambulance ride

Each of these factors is unique to you. Each has a significant impact on your resultant ambulance costs and insurance coverage.

What is “medically necessary”?

Before diving into the nuance of insurance and ambulance services, you should know the term “medically necessary.” Most insurance providers will only cover ambulance rides that they consider medically necessary. This term means that your condition is such that any other mode of transportation is contraindicated. In other words, your ambulance ride must be emergent, necessary, and reasonable.

Which insurance covers ambulance rides?

Typically, two types of insurance cover ambulance services: car and health insurance. It’s more complex than it may sound. There are a variety of conditions that impact whether either or both insurances cover your ride. It can be complicated to filter through these many conditions. We’re here to help.

Does car insurance cover ambulance rides?

1,436,463 – that’s the number of motor vehicle crashes that emergency medical services responded to in 2021. Car insurance can cover ambulance rides, but it’s not guaranteed. Most car insurance providers have three main criteria you must meet to get reimbursed for some ambulance ride costs:

  1. Your injury and consequential ambulance ride relate directly to a car accident.
  2. Your policy contains personal injury protection (PIP).
  3. The ambulance ride is medically necessary.

Unfortunately, auto insurance rarely covers the total cost of an ambulance ride. If the following conditions are true, you have the best chance of getting maximum coverage.

  • Your ambulance takes you to the nearest hospital.
  • The ambulance provider is within your approved network.
  • If your hospital services directly relate to your car accident, you may be eligible for reimbursement for those through your car insurance policy.

Every car insurance company handles ambulance rides differently. Furthermore, each policy has different limits and restrictions. Now you know some potential conditions which warrant car insurance coverage. The next step is contacting your insurance provider to see how your unique situation meets their specific criteria. Read on to find out what to do when you get your bill.

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Does private health insurance cover ambulance rides?

Like car insurance, it’s common for private health insurance to cover ambulance costs (and even car accident bills), but only under certain conditions. Here are some questions to ask yourself to determine how much insurance coverage you are eligible for.

Are ambulance services covered under my policy?

While it’s common for them to be covered, ambulance rides aren’t always included in health insurance policies. Check with your provider to determine whether your ride is eligible for coverage under your current policy.

Have I met my annual deductible?

As determined by your health insurance policy, your deductible is a fixed amount you must pay in medical expenses before you are eligible for coverage. It could be hundreds or even thousands of dollars. Once you meet the deductible, your insurance policy will cover your medical costs, less any other limitations.

Am I responsible for a copay or coinsurance?

Your insurance company may require that you pay a set amount (a copay) for an ambulance ride. Or you might have to pay coinsurance, which is the amount you owe after you meet your deductible. If either of these applies to your health insurance policy, you will have to pay at least some of your ambulance bills.

Was the ambulance company in-network?

Insurance companies typically have a list of “in-network” healthcare providers. The insurance company partners with these providers and may cover your bills from them. If providers aren’t on that list, they are considered “out-of-network.” Coverage for out-of-network providers could be much lower, or even zero, depending on your insurance company.

You can rarely choose your ambulance company in emergencies, but you can call your insurance provider afterward to see if they cover ambulance rides and if yours was in-network.

Do I have accident insurance?

If you have a high-risk lifestyle and are prone to accidents, accident insurance is an excellent supplement to your regular health insurance. You can add accident insurance to your health insurance coverage. It gives extra coverage for out-of-network providers, including ambulance services.

Do Medicare and Medicaid cover ambulance rides?

The United States government offers affordable public health insurance programs, Medicare and Medicaid, to those in need. Like other types of insurance, whether or not they cover ambulance rides depends on your plan.

Medicare for ambulance rides

Medicare Part B resembles private insurance. If you have this type of Medicare insurance, you can get some ambulance service coverage. However, there may be limitations such as deductibles, copays, etc. With Medicare Part B, you must meet the following three criteria to get assistance with your ambulance bills.

  • The ride must be medically necessary. Traveling in any other vehicle to a hospital or skilled nursing facility could have endangered your health.
  • You must meet your Medicare deductible.
  • You must pay 20% of the Medicare-approved amount.

Medicaid for ambulance rides

Medicaid is simple when it comes to ambulance rides. Your Medicaid plan will cover your ambulance ride as long as it is for emergency medically-necessary transportation and the state licenses the ambulance company.

Pro Tip

Under Medicaid, you can get non-emergency rides, too. As long as it’s medically necessary for you to get to a Medicaid medical provider, Medicaid will provide transportation. Keep in mind that conditions for this service vary by state.

Can I use both car and health insurance to cover ambulance services?

Yes! Suppose your ambulance ride was medically necessary, and you meet the conditions of both insurance plans. In that case, your car and health insurance plans can work together to help cover your ambulance bill.

The cost of riding in an ambulance

Either you’ve heard about it, or you know it first-hand. Ambulance rides are costly. Like most medical services, the cost varies. ALS (advanced life support) ambulance services typically cost more than BLS (basic life support) ones. This price difference is mainly due to the need for a paramedic and emergency medical technician in an ALS ambulance ride. In contrast, BLS ambulance services require only emergency medical technicians. Other than ALS vs. BLS, the following are some factors that impact the cost of an ambulance ride.

  • Ground transport mileage
  • Physical examinations
  • Health services, including IV, oxygen, and more
  • The state where you live

How much does an ambulance ride cost without insurance?

While ambulance costs are inevitably variable based on situation, life support needs, and provider, we can look at past data to predict the price. According to a FAIR Health study of ground ambulance services in the United States, the average ALS ambulance ride cost $1,277 in 2020. In the same year, the average BLS ambulance ride cost $940.

Ambulance services saw about a 20% increase from 2017 to 2020. If we assume this same rate in 2023, you can expect an ALS ambulance ride to cost an average of about $1,500 and a BLS ambulance ride to cost an average of about $1,100. Ambulance ride pricing isn’t government-regulated, and studies have shown the highest costs to be up to $20,000 for one medical transport. Without insurance, you’ll be responsible for covering this total cost plus any additional medical expenses incurred during your emergency.

How much does an ambulance ride cost with insurance?

You could still be responsible for 100% of the ambulance expenses, even with insurance. This is likely to be the case if the ambulance company and 911 dispatcher were out-of-network, you haven’t met your deductible, and you don’t have personal injury protection (PIP) coverage.

On the other hand, insurance can cover the total cost of your ambulance ride. If you meet the criteria listed above, you’ve got a good chance of paying $0 of your ambulance bill.

Commonly, insurance will cover part but not all of your insurance. Partial coverage happens in several scenarios. For example, the following might lead to partial insurance coverage.

  • You’ve met part, but not all, of your deductible.
  • You have a copay.
  • You have Medicare Part B and are responsible for 20% of the approved cost.
  • You exceed your PIP coverage limit.

Think about it — even if insurance only covers 25% of your ambulance bill, that’s hundreds of dollars saved on your end.

What to do when you get an ambulance bill

Most of the work in processing an ambulance bill with insurance happens between the ambulance company and the insurance company. In most cases, you’ll give the ambulance company your insurance information, and they will contact your insurance company. You’ll likely receive a bill from your insurance company detailing the cost and what you owe. If you have any questions or concerns, want to see an itemized bill, or think there has been a mistake, contact your insurance company or the ambulance company.

And you don’t have insurance

If you don’t have health or car insurance and you have to take a ride in an ambulance, the ambulance company will send you your bill directly. Your best bet for saving money is to talk to the ambulance company and try to get some items lowered or get on a payment plan. You can also look into personal loans — check out our list of the best loans for medical expenses.

FAQ

How much is an ambulance ride without insurance in America?

The average life support ambulance ride in America cost $940 in 2020. An average advanced life support ambulance ride cost $1,277 in 2020. But those are just averages — the out-of-pocket costs could be much more.

Should I call an ambulance or not?

You should call an ambulance if you are in an emergency medical situation and cannot safely drive to get medical attention. If you have insurance, it may at least partially cover medically necessary ambulance services.

Why are ambulance calls so expensive?

Ambulance calls are expensive because they require a lot of resources, equipment, and highly trained staff. Additionally, ambulance companies are not regulated, so some may inflate their prices for increased profit.

Is it faster to drive to the hospital or call an ambulance?

The answer to this question depends on how far you live from a hospital and your medical emergency. The average response time for emergency medical services is seven minutes. Once an ambulance arrives, you benefit from immediate medical attention. Weigh your options based on the severity and urgency of your condition, and do not attempt to drive if that would put you in more danger.

Key takeaways

  • If you have some form of car or medical insurance, you may not have to cover your ambulance bill alone. Both offer coverage for ambulance services if your ambulance ride is medically necessary.
  • Your car insurance will likely cover your ambulance ride if you have met your deductible, your ambulance ride directly relates to a car accident, and you have personal injury protection (PIP) coverage included in your policy.
  • Both private and public health insurance providers offer ambulance transport coverage. You will likely benefit from this coverage if you’ve met your deductible and the ambulance company is in-network.
  • Different scenarios warrant different levels of ambulance response. Advanced life support ambulance services will cost more than basic life support ambulance services.
View Article Sources
  1. Emergency Medical Services Response Times in Rural, Suburban, and Urban Areas – National Library of Medicine
  2. 2Post-Crash Care: EMS Response to MVC Injuries – National Emergency Medical Services Information System
  3. Ambulance Services – Medicare
  4. Does Health Insurance Cover Car Accident Bills? – SuperMoney
  5. What Does Your Car Insurance Cover? – SuperMoney
  6. How to Find Auto Insurance That Covers Any Driver – SuperMoney