JustCare

Tag: Ambulance

  • Two tips for keeping your emergency care costs down

    Two tips for keeping your emergency care costs down

    There were 451 emergency room visits for every 1,000 people in America in 2014, up more than 10 percent in the last decade. Medicare always covers emergency care. But, the ambulance trip and the emergency room visits can be very expensive if you are not prepared.  Here are two tips to keep your emergency care costs down.
    1. Find a local ambulance that your health plan covers and keep the number in a safe place.
      • If you have traditional Medicare, the government-administered program, find the number for a Medicare-certified ambulance. So long as you have supplemental coverage, your costs should be covered in full.
      • If you are enrolled in a Medicare Advantage plan, a commercial health plan that offers Medicare benefits, or any other commercial health plan, find the number for an in-network ambulance. Otherwise, your costs could be exorbitant. Unless your insurer has negotiated a price with an ambulance company, that company can charge what it pleases. No one controls the price of ground ambulance services. Kaiser Health News reports that patients in commercial health plans are increasingly facing sticker shock from the cost of their ambulance services.
      • If possible, avoid calling 911 for an ambulance because you may have no control over whether your insurer will cover the ambulance services or whether the ambulance will take you to an in-network hospital. Much like surprise medical bills that patients receive from out-of-network doctors who see them when they are admitted to their in-network hospital, bills from ambulance companies that are not part of a health plan’s network can be in the thousands of dollars. A January 2017 Health Affairs study finds that more than 125,000 of 500,000 ambulance trips in 2014 were out of network.
    2. Call your health plan to understand your out-of-pocket costs for emergency room care and what you can do to minimize them.
      • If you have traditional Medicare, Medicare combined with your supplemental coverage should pick up your costs.
      • If you are in a commercial Medicare Advantage plan, administered by a private insurance company, you will be covered for out-of-network care in an emergency for emergency room services. Your health plan cannot bill you more than $50 for those services. Medically necessary follow-up care is also covered when your health is endangered.
      • If you are not yet eligible for Medicare and enrolled in a commercial health plan, you are guaranteed some protections under the law; but, it is best to know your health plan’s rules.

    If Congress expanded Medicare to cover everyone in the US, as Senator Bernie Sanders and 15 other Senators have proposed, it would protect everyone from surprise medical bills, including surprise ambulance bills. For now, Representative Lloyd Doggett has introduced a bill that would protect patients from surprise medical bills.

    If you want Congress to expand Medicare to everyone in the US, please sign this petition.

    Here’s more from Just Care:

  • Two ways to make sure Medicare covers ambulance services

    Two ways to make sure Medicare covers ambulance services

    Medicare covers ambulance services when they are medically necessary. Here’s how to ensure Medicare will pay:

    1. Be prepared. Identify an ambulance company to use. Confirm with your local ambulance service that it is Medicare-certified. If you are enrolled in a Medicare Advantage plan, find out which ambulance is in the health plan’s network.
    2. Only use an ambulance if you have an immediate health risk or are bed-bound and require constant monitoring.  And, make sure that the ambulance will take you to the hospital you want to use if there is more than one hospital in your area.  Under the law, the ambulance generally must take you to the nearest hospital.

    If you want Medicare to pay for ambulance services, do not use an ambulette. Medicare will not cover it. For more information, visit Medicare Interactive.