Does Medicare Cover Air Ambulance? — What You Need To Know

Medicare doesn’t always cover air ambulance transportation, and misunderstanding the rules can cost you thousands.

In this article, we’ll break down everything you need to know about Medicare’s air ambulance coverage, including eligibility requirements, limitations, and how the claims process works. You’ll also learn how Medicare plans differ, and why travel insurance matters—especially if you’re going abroad.

If your loved one needs urgent care that can’t be reached by ground transportation, REVA provides medically equipped air ambulance flights to keep them safe from takeoff to landing. Contact us today to arrange an air ambulance flight– we’re available 24/7 to coordinate insurance coverage and minimize your out-of-pocket costs.

Understanding Medicare Coverage for Air Ambulances

Medicare does cover costs for air ambulance services—but only under specific conditions. It’s important to understand how coverage works under the two parts of traditional Medicare:

• Medicare Part A: This covers hospital-related services, including inpatient care. If you’re admitted to a hospital, Part A may cover the facility charges associated with medically necessary air ambulance transport.
• Medicare Part B: This covers outpatient care, doctor’s visits, and services like ambulance transportation, including air ambulance when ground transport isn’t viable.

These government-funded programs primarily serve seniors over 65 and individuals with disabilities. However, coverage is not automatic—and Medicare imposes strict criteria to determine medical necessity and appropriate use.

Restrictions on International Medical Flights

While Medicare typically covers medically necessary care within the U.S., it imposes limitations for international services. Most of REVA’s air ambulance flights originate outside of the U.S., particularly in the Caribbean. In these cases, Medicare will almost never cover the cost, even in emergencies.

Exceptions are limited, and typically only apply if:

• A foreign hospital is closer than a U.S. hospital
• You are traveling between Alaska and another U.S. state and must pass through Canada
• You experience a medical emergency while traveling in the U.S., but the nearest hospital is in another country (e.g., Mexico or Canada)

If your situation doesn’t meet these exceptions, you’ll likely be responsible for the full cost of the international air ambulance.

Domestic Coverage Within the Continental U.S.

Medicare will cover air ambulance flights within the U.S. when:

• The flight is medically necessary, meaning ground transportation would endanger the patient’s health
• The patient is transported to the nearest appropriate medical facility capable of providing the level of care they need 

Keep in mind, Medicare does not allow you to choose a hospital based on preference—coverage only applies for the closest suitable facility. Even if the above conditions are met, you may still have cost-sharing responsibilities. Under Original Medicare:

• Part B typically covers 80% of the Medicare-approved amount for air ambulance services
• You are responsible for the remaining 20%, unless you have supplemental insurance (Medigap) to cover the gap
• If you’re on a Medicare Advantage plan, coverage rules and provider networks may vary, and prior authorization may be required

To avoid surprise bills, always verify your plan’s terms.

Conditions Covered by Medicare for Air Ambulance

Medicare covers both emergency and non-emergency air ambulance services—but only if specific, medically necessary conditions are met. The decision to approve coverage is based on urgency, safety, and access to care.

Medicare may approve air ambulance coverage when:

• Ground transportation isn’t safe or possible due to the patient’s condition (e.g., severe trauma, stroke, cardiac arrest, or other time-sensitive emergencies)
• The originating facility lacks the staff, equipment, or resources to treat the patient appropriately
• The receiving hospital is the closest appropriate facility capable of delivering the required treatment—Medicare will not pay for transport to a more distant hospital for convenience or patient preference.

How Medicare Determines Medical Necessity

To receive coverage for an air ambulance trip, medical necessity for Medicare is often determined by:

• Clinical documentation from a physician
• Input from a hospital case manager or discharge planner
• The availability (or lack) of local services like trauma care, burn units, or neurosurgery

It’s also important to note that Medicare will not pay for air ambulance flights to a preferred provider if an equivalent facility is closer. The rule is always “closest appropriate facility”—not the best, not the most familiar, but the nearest capable one.

How to Obtain Medicare Coverage for Air Ambulance

To find out whether your air ambulance flight is covered by Medicare, the first step is to review your Medicare benefits package. This document, which is typically sent via mail or email, outlines what your plan includes—whether you’re enrolled in Original Medicare (Parts A and B) or a Medicare Advantage (Part C) plan.

Unlike many private insurance providers, Medicare does not require pre-authorization for emergency air ambulance services. However, coverage is not guaranteed, and reimbursement depends on whether the trip meets Medicare’s strict standards for medical necessity and proximity to care.

Coverage information is coordinated and shared with the air ambulance provider by:

• The patient
• A hospital case manager
• The discharging physician

If you’re covered under a Medicare Advantage plan, be aware that:

• The plan may require prior approval even in urgent cases
• You may be restricted to network providers
• Your out-of-pocket costs may differ from those under Original Medicare

It’s important to contact your plan administrator or work with an experienced air ambulance provider like REVA to verify coverage before flying, especially for non-emergency transfers.

Key Considerations Before Booking an Air Ambulance with Medicare

If you’re planning to travel abroad, it’s highly recommended to purchase travel insurance with emergency medical evacuation coverage. Medicare does not cover most air ambulance services outside of the U.S., so a travel policy can protect you from enormous out-of-pocket costs if a medical emergency occurs.

When booking an air ambulance flight as a Medicare beneficiary, follow these steps to protect your health and your finances:

• Verify that the treating provider and receiving facility are in-network with Medicare or your Medicare Advantage plan. Out-of-network care may lead to denied claims or higher costs.
• Confirm that your air ambulance provider understands Medicare’s coverage rules, especially when it comes to international transfers. 
• Ask if documentation is in place to support medical necessity, particularly for non-emergency flights. This may involve physician statements, facility discharge summaries, or case manager input.

Confirming these details before your flight can make all the difference in your Medicare coverage.

Ground Ambulance vs. Air Ambulance: Medicare Rules

Medicare applies strict criteria when deciding whether to cover air ambulance over ground ambulance services. Air ambulance will not be covered if ground transportation is considered:

• Safe
• Medically appropriate
• Able to reach a local facility capable of treating the patient

Even when a patient is in critical condition, if a ground ambulance can reasonably access the nearest facility with the required level of care, Medicare may deny the air ambulance claim.

In contrast, if the sending facility lacks specialized services like burn units, neurosurgery, stroke centers, or cardiac catheterization labs, an air ambulance may be justified. In these cases, Medicare will evaluate whether the patient’s condition would be jeopardized if transported by ground ambulance.

It’s important to note that Medicare claims are processed through regional contractors, so coverage guidelines can differ slightly depending on your state of residence. Always review your specific policy before booking an air ambulance.

Arrange An Air Ambulance with REVA

If your loved one is in critical condition and cannot access care by ground ambulance, REVA keeps them safe and stable in the air. Our air ambulances are equipped like flying ICUs and staffed by flight nurses, caring for patients of all acuity levels from takeoff to landing.

Contact REVA today to arrange an air ambulance. We’re always available to discuss your insurance coverage options– whether with Medicare or private insurance– to reduce your out-of-pocket costs.