Does Health Insurance Cover Ambulance Bills? Surprisingly, It’s Complicated

Ground transportation to another facility, which is typically provided by an ambulance, can be a necessary part of medical care. But who is responsible for paying the ambulance bill?

According to the Affordable Care Act (ACA), health insurance plans must cover essential health benefits (EHBs), including ambulance services. However, there are some important exceptions to this rule.

One exception is if the ambulance transport is not medically necessary. For example, if you are transported to the hospital by ambulance for a non-emergency condition, your health insurance plan may not cover the cost of the ambulance.

Another exception is if the ambulance transport is provided by an out-of-network provider. In this case, your health insurance plan may only cover a portion of the cost of the ambulance, and you may be responsible for the remaining balance.

For Medicaid ambulance services, if you qualify for Medicaid, you will not be billed for ambulance services. Medicaid will cover the cost of the ambulance transport, regardless of whether the ambulance is in-network or out-of-network.

If you do not have health insurance, you will be responsible for the full cost of the ambulance transport. However, you may be able to negotiate a payment plan with the ambulance company.

Here are some tips for avoiding surprise ambulance bills:

Talk to your doctor about your transportation options before you are transported to the hospital. If possible, ask your doctor if there are any alternative transportation options that would be less expensive.
If you are transported to the hospital by ambulance, ask the ambulance company for an estimate of the cost. This will help you avoid any surprises when you receive the bill.
If you are unable to pay the ambulance bill, contact the ambulance company and ask about payment plans. Many ambulance companies offer payment plans that can make it easier to pay off the bill over time.

Conclusion

Ambulance bills can be expensive, but there are ways to avoid surprise bills. By talking to your doctor about your transportation options and asking the ambulance company for an estimate of the cost, you can help to ensure that you are not responsible for an unexpected bill.

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