Does Health Insurance Cover Ambulance Rides?
Health insurance covers medically necessary and some nonemergency ambulance rides. Consider using in-network providers to avoid extra costs. To date, 14 states have passed laws to protect you from ambulance balance billing.
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By Mark Fitzpatrick
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Head of Insurance, MoneyGeek
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including [CNBC](https://www.cnbc.com/2020/04/15/cant-keep-up-with-insurance-premiums-heres-what-to-do.html), [NBC News](https://www.nbcnews.com/business/autos/flooded-cars-are-problem-their-owners-future-car-buyers-n1278493) and [Mashable](https://mashable.com/article/tesla-insurance-rates). Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
Edited by Casie McCoskeyCasie McCoskey is a professional editor passionate about providing people with accessible information on personal finance. Before MoneyGeek, she worked in the legal field, drafting and editing briefs and motions.
MF
By Mark Fitzpatrick
MF
Head of Insurance, MoneyGeek
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including [CNBC](https://www.cnbc.com/2020/04/15/cant-keep-up-with-insurance-premiums-heres-what-to-do.html), [NBC News](https://www.nbcnews.com/business/autos/flooded-cars-are-problem-their-owners-future-car-buyers-n1278493) and [Mashable](https://mashable.com/article/tesla-insurance-rates). Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
Edited by Casie McCoskeyCasie McCoskey is a professional editor passionate about providing people with accessible information on personal finance. Before MoneyGeek, she worked in the legal field, drafting and editing briefs and motions.
Updated: June 10, 2024
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Health insurance typically covers ambulance rides when medically necessary, with potential coverage for nonemergency and postemergency services.
However, the details can vary depending on your plan and state regulations. For instance, 14 states have enacted laws to protect consumers from unexpected balance billing for ground ambulance services. California is the most recent addition, implementing legislation on January 1, 2024.
Understanding your coverage limits and network restrictions will help you navigate these costs effectively in an emergency.
Health insurance will generally cover ambulance services when using an ambulance is the safest and quickest way to transport you to a medical facility in an emergency. In some cases, health insurance plans may also extend coverage to ambulance transports in nonemergency situations, such as when a hospital cannot provide adequate care or when transitioning to specialized care facilities becomes necessary.
When using ambulance services, it is advisable to choose an in-network provider whenever possible. Opting for an in-network provider can significantly reduce costs compared to booking an ambulance outside your insurance network. However, even if you choose an in-network provider and your policy covers ambulance services, you may still be responsible for paying a copayment or co-insurance as part of your coverage.
It's also wise to be aware of potential restrictions on your policy's coverage. Typically, insurance policies cover transportation to the nearest hospital that can provide appropriate services. If your ambulance takes you to the second-closest hospital, you might be responsible for paying more of the bill.
Given that the specifics of coverage can vary widely depending on the type of insurance plan you have selected, review your summary of benefits to make informed decisions about your health care needs.
Health insurance typically covers air ambulance services in medical emergencies. Some plans may cover the medical care required during transportation, including essential equipment like oxygen or life support.
The No Surprises Act mandates that emergency air ambulance services must be billed at in-network rates, even if the provider doesn't have a contract with your insurer. This means you will be responsible for paying the deductible, co-insurance and copayment as if the air ambulance provider were in-network. However, the law does not apply to ground ambulance rides.
Medicaid covers ambulance rides for emergencies without cost-sharing for beneficiaries. However, coverage and potential cost-sharing requirements can vary by state.
Medicaid also includes coverage for nonemergency medical transports when ordered by a physician. Verify the specific coverage in your state through your state's Medicaid program or Medicaid managed care plan.
Medicare Part B covers ground and air ambulance rides in emergencies. Limited coverage for nonemergency transports is available with a physician's written order.
For emergency ambulance services, Medicare typically covers 80% of the approved amount, with the beneficiary responsible for the remaining 20% and any applicable deductibles. Review your Medicare plan's details or contact Medicare for precise coverage and potential out-of-pocket expenses.
In some specific conditions, health insurance may also cover ambulance services in case of nonemergencies, like in the below scenarios:
Inadequate Care: If the original hospital you were taken to cannot provide adequate care, your insurance may cover transport to the closest in-network hospital that can provide necessary medical care. This gives you access to the appropriate treatment without incurring additional expenses.
Transition of Care: Sometimes, health insurance plans cover ambulance transport from a short-term or acute care facility to the closest long-term acute care facility. Similarly, transport from a hospital to a rehabilitation facility when additional medical care is required may also be covered. These provisions can be essential for individuals in need of specialized care.
Fourteen states in the United States have enacted laws to protect consumers from balance billing by ground ambulance providers. California, the most recent state to enact such legislation, has implemented these laws effective January 1, 2024, ensuring that Californians with state-regulated health insurance receive protection against excessive charges from out-of-network ground ambulance providers.
These laws vary in their approaches to safeguarding consumers, from setting rates for out-of-network ground ambulance payments to explicitly prohibiting ground ambulance balance billing. The table below highlights states' differing consumer protections regulating surprise billing for various ambulance services and providers.
