Medical Transport Insurance: Who Qualifies?

Medical transport insurance is a type of insurance coverage that helps pay for medical transportation services. This insurance is designed for individuals who may require specialised transportation to access medical care or treatment due to their medical condition. It is usually separate from standard health insurance or Medicare policies. Medical transport insurance can provide financial protection for emergency medical transportation, which is often not fully covered by regular health insurance plans. This type of insurance can be particularly useful for individuals who need to travel long distances or require specialised transport options, such as air ambulances. Additionally, it can assist those who need non-emergency medical transportation for regular medical appointments or non-urgent situations.

Ambulance services deemed medically necessary

Ambulance services are deemed medically necessary when a patient's health is in serious danger and they cannot be transported safely by other means. In the United States, Medicare Part B (Medical Insurance) covers emergency ambulance services if certain conditions are met.

Medicare Part B covers emergency ambulance services if:

• An ambulance is deemed medically necessary, meaning it is the only safe way to transport the patient.
• The patient is being transported to and from certain locations, following Medicare's coverage guidelines. These locations include critical access hospitals, rural emergency hospitals, and skilled nursing facilities.
• The transportation supplier meets Medicare ambulance requirements.

Medicare may also cover non-emergency ambulance services in limited cases. To be eligible for coverage of non-emergency ambulance services, the patient must be confined to their bed and unable to get up without help, or they must require vital medical services during their trip that are only available in an ambulance, such as medication administration or vital function monitoring.

In some cases, Medicare may pay for medically necessary, non-emergency ambulance transportation if the patient has a written order from their doctor stating that transportation is medically necessary. For example, a patient with End-Stage Renal Disease may require medically necessary ambulance transport to and from a kidney dialysis facility.

Medicare Advantage (MA) plans, also known as Part C, often offer broader transportation benefits than Original Medicare, including rides to doctor's appointments and specialty care. Special Needs Plans have even wider coverage for medical transportation and are designed for individuals living in nursing homes or those with chronic conditions who qualify for both Medicare and Medicaid.

Non-emergency medical transport

NEMT is often used for routine doctor's appointments, ensuring that individuals can receive regular check-ups and preventive care, which is essential for managing chronic conditions and maintaining overall health. It is also used for:

• Dialysis treatments
• Physical therapy and rehabilitation
• Mental health services
• Chemotherapy or radiation therapy
• Hospital discharges
• Pharmacy visits

In the United States, Medicare and Medicaid often cover non-emergency medical transportation (NEMT) for eligible disabled beneficiaries. Additionally, some Medicare Advantage plans may also offer coverage for non-emergency transportation services.

There are also private non-emergency medical transportation companies that individuals can pay out of pocket for. These companies often offer services such as wheelchair-accessible vehicles and gurneys.

Emergency flights/helicopter rides

Emergency flights and helicopter rides can be life-saving, but they often come with a high price tag. The national average for an emergency helicopter ride in the US is about $40,000, and this figure rose by 60% between 2012 and 2016. The median cost-per-mile has reached $268, according to a 2019 study. This cost is far higher than other methods of long-distance medical transport.

The urgency of emergency flights and helicopter rides often means that patients have no choice in who provides the airlift to the hospital and, therefore, cannot control whether the provider is in or out of their insurance network. This can result in "surprise billing", where patients are charged tens of thousands of dollars.

Medicare Part B (Medical Insurance) covers emergency flights and helicopter rides in certain circumstances. Medicare will pay for emergency transportation in an airplane or helicopter if your health condition requires immediate and rapid ambulance transportation that ground transportation can't provide. However, Medicare will only cover transportation to the nearest appropriate medical facility that is able to give you the care you need.

Medicaid may also cover air ambulance services in some instances of medical necessity.

If you have private insurance, check your policy with your comprehensive health care insurer to see if emergency flights and helicopter rides are covered. In most cases, an urgent medical need, documented by a physician, is required for reimbursement.

Medical transport insurance plans

Medical emergencies can happen anytime, anywhere. While standard health insurance plans typically do not cover emergency medical transportation services, medical transport insurance plans can provide financial protection in such situations. These plans are designed to assist individuals who require specialized transportation to access medical care or treatment due to their medical condition.

Types of Medical Transport Insurance Plans

Medicare Plans

Medicare Part B (Medical Insurance) covers ground ambulance transportation when travelling in any other vehicle could endanger your health, and you require medically necessary services from critical access hospitals, rural emergency hospitals, or skilled nursing facilities. Medicare may also cover emergency transportation in an airplane or helicopter if immediate and rapid transport is required.

Original Medicare (Part A and Part B) generally does not cover transportation for routine medical appointments. However, it may cover non-emergency medical transportation deemed medically necessary, such as transportation to dialysis for someone with permanent kidney failure or end-stage renal disease (ESRD).

Medicare Advantage (Part C) plans may offer broader transportation benefits, including rides to doctor's appointments, physical therapy, and even fitness centres. These plans often cover non-emergency medical transportation (NEMT) and, in some cases, may also extend to emergency medical transportation (EMT).

Private Insurance Plans

Private insurance companies, such as MASA Medical Transport Solutions, offer dedicated medical transport plans. These plans provide emergency medical transportation benefits, ensuring individuals are not burdened with substantial unexpected bills.

Travel Assistance Plans

If your concern for medical transportation is related to travel, a travel assistance plan may be a suitable option. For example, Emergency Assistance Plus (EA+) offers a membership plan that provides emergency medical evacuation and transportation services worldwide, ensuring individuals receive proper medical care and necessary transportation home.

Factors Affecting the Cost of Medical Transportation

When considering medical transport insurance plans, it is essential to understand the factors influencing the cost of medical transportation:

• Distance: Longer distances generally result in higher transportation costs.
• Type of Vehicle: Specialized transport options, such as air ambulances or critical care transport units, tend to be more expensive than basic ambulance services.
• Level of Care: Advanced life support (ALS) or critical care transport, requiring specialized medical equipment and staff, is typically more costly than basic life support (BLS) transportation.
• Location: Transportation services may be more expensive in areas with a high cost of living.
• Insurance Coverage: The extent of coverage varies among plans, with some covering all or part of the transportation costs.
• Emergency vs. Non-Emergency: Emergency medical transportation services, such as ambulance services, are usually more expensive than non-emergency transportation for scheduled medical appointments.
• Time: Some providers may charge based on both the distance travelled and the time required for the journey.

Benefits of Medical Transport Insurance Plans

• Financial Protection: These plans help individuals avoid the financial burden of emergency medical transportation, which can be substantial.
• Access to Healthcare: By covering transportation costs, these plans ensure individuals can access necessary medical care and treatments without barriers.
• Peace of Mind: Individuals can rest easy knowing that they are protected from unexpected bills and have reliable transportation options during medical emergencies.
• Enhanced Well-Being: Regular medical appointments and treatments are vital for managing chronic conditions and maintaining overall health.
• Improved Quality of Life: Accessible transportation options enhance the quality of life for individuals with mobility challenges, enabling them to participate in social activities and engage with their community.

Choosing the Right Medical Transport Insurance Plan

When selecting a medical transport insurance plan, it is important to carefully review the coverage details, eligibility criteria, and specific requirements of the plan. Additionally, consider the reputation and experience of the insurance provider to ensure they have a comprehensive understanding of your needs and can provide maximum protection.

Travel assistance plans

A prime example of a travel assistance plan is Emergency Assistance Plus (EA+), which offers protection from the financial burden of emergency medical evacuation and transportation. With EA+, you can have peace of mind knowing that, no matter where you are in the world, a team of highly skilled professionals is ready to assist you. They will ensure you receive the medical care you need and provide transportation back home, all covered by your annual membership fee. This is particularly beneficial for individuals with medical conditions that require specialised transport, such as non-emergency medical transportation (NEMT) or emergency medical transportation (EMT).

NEMT services are typically provided by medical clinics, private ambulance services, or transportation providers. These vehicles are not equipped to handle emergencies but are crucial for transporting patients to and from appointments, especially for those with chronic conditions or mobility limitations. On the other hand, EMT services are designed for medical emergencies and are usually operated by private ambulance services, governmental fire and rescue services, or public hospital districts. They are equipped with diagnostic and life-saving equipment, allowing EMTs and paramedics to provide immediate treatment.

When it comes to costs, medical transportation can be expensive, and regular health insurance often covers only a portion of the expenses. This is where travel assistance plans shine. They ensure that you have zero out-of-pocket expenses for any emergent air or ground transportation within their coverage area. For example, MASA Medical Transport Solutions (MASA MTS) offers world-class emergency medical transportation benefits, providing peace of mind for individuals and their families.

In conclusion, travel assistance plans, such as EA+ and MASA MTS, offer valuable protection against the financial burden of medical transportation services. They ensure that individuals can access the specialised transportation they need during their travels, without worrying about unexpected costs. With their annual membership fees, these plans provide a comprehensive solution for anyone seeking peace of mind while travelling, especially those with medical conditions requiring specialised transport.

Frequently asked questions