Does Medicare cover ambulance transfers?

[Dennis S]

My Mom has to travel 50 miles to a bigger hospital for a kidney stone pulviraztion. She has Medicare and AETNA insurance. My sister wanted to just drive her because the same transfer for her husband cost $1000, although he didn't have Medicare, but did have "good" insurance.

Mom is not in pain and feels up to the ride in a car. Also, her grand-daugher is a nurse and would go along.

Does anyone know "yes or no" about Medicare and non-emergency transfers. Also, this local hospital has run countless tests and just come to this conclusion after 3 days, even though mom told them she had a kidney stone once before and this felt like the exact same thing.

[Blurb]

I don't know for sure, but I know Medicare pretty well, and I would guess in this circumstance they would likely NOT pay for an ambulance transfer. I believe the only reason they pay is if the level of care is required by the patient's condition throughout the time of the transfer, e.g., they require a heart monitor, or to maintain an IV drip, or respiratory assistance/support.

Your sister is correct, and you should take advantage of her gdtr's offer.

[Go To Top]

No. Would not pay my bill on two occasions.

[rjmacs]

In most cases, Medicare will not cover ambulance transport between hospitals if the patient is well enough to travel by car. If she's well enough to travel by car, she's not an inpatient-to-inpatient transfer. She'd be discharged from one hospital and sent to be admitted to the next one as a new patient.

If you really want to know, ask the hospital's utilization management office or social worker. If it's not covered by Medicare, the ambulance company will probably require you to sign something agreeing to pay before they'd be willing to take her. Medical transport is a dollar-driven business - if there's not a funding source, they won't take the patient.

[Dennis S]

I just got a call and they are keeping her hooked up to IV, heart and catheter, so off we go.

Thanks.