by Linda Fodrini-Johnson, MA, MFT, CMC
Ambulance transportation costs are incredibly expensive. Without Medicare coverage for an emergency, the cost of an ambulance trip could easily exceed $1,500 for a very short trip. In fact, in my county of Contra Costa, CA the base rate effective for 2016 is $2,100 plus mileage! Many people assume that if they have Medicare, transportation to a hospital by ambulance is covered. It is super important to note that the assumption is only partially right.
In a ‘qualified’ Medical Emergency, you pay only 20% of the Medicare approved fee to the ambulance company. And if you have a good Medicare-Gap policy, like I do, they will usually pick up that 20% you are obligated to pay. Of course, since this is coming from Medicare B – you must have that coverage and have met your 2016 annual deductible of $166 to get this coverage.
But there are emergencies that come up where your Medicare coverage isn’t guaranteed, and you could end up with an unexpected, costly ambulance bill. For example, if you sustained a fall, and someone made a call to 911, but your injury is not life threatening and it is determined you could have gone to the Emergency Room safely by taxicab or automobile, then the ambulance company will only take you after you sign an “Advance Beneficiary Notice” (ABN). Critically, the ABN is a legal document used by ambulance companies to make sure you are aware that Medicare might not cover the trip, and that you will be liable to pay for the full cost of the trip to them if that is the case! You do have the option on the spot to not sign the ABN if asked, and instead have a family member or a friend take you to the ER. Note that even then, there is the potential to be charged a fee for treatment and refusal of transportation by the ambulance company.
There are times when in the midst of an emergency that calling for an ambulance is clearly the right thing to do. However, when the situation is less than an emergency, take a moment to consider all your options for that short trip to the hospital to get the care you need.
