Medicare & Emergency Care: What’s Covered?

Medical emergencies can happen at any time, and knowing what Medicare covers can help you avoid unexpected medical bills. Whether it’s an ambulance ride, an ER visit, or urgent care, here’s what you need to know about Medicare and emergency care.

Does Medicare Cover Emergency Room Visits?

Yes! Medicare Part B covers emergency room (ER) visits when you have a serious or life-threatening condition. This includes:

• Doctor and specialist services in the ER

• X-rays, MRIs, and other diagnostic tests

• Emergency medical treatments and procedures

💰 Costs:

• You’ll typically pay a 20% coinsurance after meeting the Part B deductible ($240 in 2024).

• Hospital charges may apply if you're admitted.

  
  

Does Medicare Cover Ambulance Services?

Yes, but only if medically necessary—meaning transportation is required for you to receive life-saving care. Medicare Part B covers:

• Emergency ground ambulance transportation to the nearest appropriate hospital.

• Air ambulance in life-threatening situations (if ground transportation isn’t an option).

💰 Costs:

• You’ll pay 20% of the Medicare-approved amount after meeting your Part B deductible.

• If Medicare denies your claim, you may be responsible for the full cost.

  
  

Does Medicare Cover Urgent Care?

Yes, but coverage depends on your plan:

• Original Medicare (Parts A & B): Covers urgent care services, but you may pay a 20% coinsurance after meeting your deductible.

• Medicare Advantage (Part C): Often includes lower copays for urgent care visits.

  
  

Medicare Advantage & Emergency Care

If you have a Medicare Advantage (Part C) plan, you’ll have the same emergency coverage as Original Medicare, plus possible extra benefits like:

✅ Lower copays for urgent care visits

✅ Worldwide emergency coverage (varies by plan)

✅ Additional transportation benefits in some plans

How to Avoid Surprise Medical Bills

✅ Know your network: Some Medicare Advantage plans have specific emergency care networks.

✅ Ask about costs: Even in emergencies, out-of-network care could cost more.

✅ Carry your Medicare card: This ensures you receive covered services without delays.

Be Prepared—Know Your Coverage!

Emergencies are stressful enough—don’t let medical bills add to the worry. Understanding your Medicare coverage now can help you make informed decisions when it matters most.

📞 Have questions? Contact us today to ensure you have the right emergency coverage!