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My 83 yo sister fell and hit her forehead requiring 50 stitches to close resulting injury. Her husband is unable to drive at night. Would Medicare have paid for the ambulance?

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For that Medicare would have paid. Hitting her head was serious. They do not pay for just transporting unless it can be proven that is the only way to get the person to a dr.
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In my experience, Medicare will pay to take someone to the Emergency Room. But, Medicare will not pay to take someone home from the ER. Hospitals sometimes have contracts with local ambulance companies to give people going home from the ER an ambulance ride at a reduced rate. So, going to the ER is covered by Medicare (in my experience). Coming home from the ER cost $160. Without it being a special hospital rate, coming home would have been over $1,000. Be prepared to pay the ambulance company driving you home. They typically demand my credit card before tendering service.
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Yes, if they have Part B.
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yes, might have to pay the 20% co-insurance
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Just a thought--if the situation isn't particularly urgent and there's no excessive bleeding, would a taxi be a suitable option? I don't know if there is a medical service that's simpler (and less expensive) than an ambulance, the latter being "overkill" (no pun intended) in many cases.
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plum9195 Jul 2019
For 90% of my relatives, there are no taxis (or Uber) available in their area. And a fall - particularly if there is blow to the head that is bleeding- in an elderly person is certainly urgent.
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Medicare would pay to the hospital but not back to the house.
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Ricky6 Jul 2019
Medicare will cover a return ambulance trip back to the house for medical necessity reasons.
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Medicare paid for Luz to be transported by ambulance three times and tricare picked up the balance.
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If at any time a person falls with head injury, DO NOT attempt to get them up. You need to rule out head or neck fracture with a CT scan which requires 911. You also have to rule out a brain bleed which may result from a fall that the head is impacted. You tell the 911 your loved one fell and her head is bleeding and afraid to get her up. I would imagine that would constitute a medical emergency. But I'm not a doctor or anything so what do I know, right?

"Ambulance services
Medicare Part B (Medical Insurance) covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services, and transportation in any other vehicle could endanger your health. Medicare may pay for emergency ambulance transportation in an airplane or helicopter to a hospital if you need immediate and rapid ambulance transportation that ground transportation can’t provide."
https://www.medicare.gov/coverage/ambulance-services


Please note my 89 year old mom with end-stage Alzheimer's had a bad UTI leaving her unable to walk, Medicare initially refused to pay it. I think it was the way the ambulance drivers charted it and never stated she was unable to stand or walk, and severely lethargic. I filed six months worth of appeals they finally approved it. I mean I must have sent at least 25 to 30 letters and appeals. Yes six months later they finally approved it. Wow. Even when the Emergency Room doctor wrote the diagnosis that her condition was a threat to her life -- WHICH IT WAS. Symptomatic UTI to the point she was unable to stand..

She had another episode of UTI and she got septic from that. Only through the Grace of God she survived that, and efficient medical care.

If at any time you have to fight for payment, please do so. DO NOT IGNORE ANY KIND OF DENIED CLAIM. Look at your Medicare statement VERY carefully.
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Yes, partially. Supplemental will help as well. For us, it brings the price down from $2500 to $250.
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Yes as this was a true emergency. You may have to pay the 20% Medicare won’t cover or your deductible first (if you have one). She had a pretty severe laceration. I don’t think you will have an issue as she needed the ambulance transportation & it was medically justified.
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