posted on June 3, 2024
Senior Medicare Patrol
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This month’s Fraud Fact from the Missouri SMP (Senior Medicare Patrol) focuses on how to
protect yourself from ambulance fraud.

Did you know Medicare covers ambulance services? To be covered it must be medically
necessary, the crew and ambulance must meet certain standards, and it must be the only safe
transportation option to the nearest Medicare covered health care center.

It’s important to review your Medicare Summary Notice (MSN) or Explanation of Benefits
(EOB) carefully to detect errors or potential fraud and abuse. If you’ve recently been transported
by ambulance look over your MSN over to verify:

  • You were not billed more miles than the actual distance of transport.
  • You were not billed for emergency transportation if there was no emergency.
  • The appropriate service was billed (for example, basic life support vs. advanced life
    support).

Be aware that Medicare will deny the claim if:

  • You could have safely been transported by a wheelchair van or another vehicle.
  • You were transported in an unapproved vehicle, like a taxi or OATS bus.
  • Your ambulance did not have two emergency medical technicians (EMTs).
  • You were taken to a non-covered destination such as your doctor’s office, independent
    labs, clinics, etc.

If you suspect there may have been errors, fraud or abuse relating to ambulance transportation
or any Medicare service, call the Missouri SMP at 1-888-515-6565.

This project was supported, in part, by the U.S. Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $662,347 with 100 percent funding by ACL/HHS. The contents are those of the author and do not necessarily represent the official views of , nor an endorsement by, ACL/HHS, or the U.S. Government

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Comments 41

  3. ericmosely727@gmail.com
    • Reply

    very good info about using an ambulance

  4. keithoproctor
    • Reply

    good info..was charged years ago for service that i didn’t ask for that
    complicated my credit score…

  16. bonnie
    • Reply

    Thanks for this information. I didn’t know all of this.

  18. Ella Smith
    • Reply

    I learn a lots about the ambulance services. That was very interesting to me;

    • Stephanie Patrick
      • Reply

      Part A does not cover ambulance services. Part B covers medically necessary emergency and non-emergency ambulance services at 80% of the Medicare-approved amount. In most cases, you pay a 20% coinsurance after you meet your Part B deductible ($240 in 2024). All ambulance companies that contract with Medicare must be participating providers. For more information on Medicare related questions, please contact MO SHIP at 800-390-3330.

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