How TRICARE Covers Ambulance Services

Photo By Airman 1st Class Jordan Gonzalez | U.S. Air Force Airman 1st Class Ethan Davis, 52nd Healthcare Operations Squadron emergency medical technician, poses in front of an ambulance with an emergency kit, September 13, 2023, at Spangdahlem Air Base, Germany. Davis is responsible for operating the ambulance and providing care for people in need of emergency services. (U.S. Air Force photo by Airman 1st Class Jordan Gonzalez)  

FALLS CHURCH, VA, UNITED STATES

01.17.2024

Courtesy Story

Defense Health Agency

In some emergencies, an ambulance could be the difference between life and death. Fortunately, your TRICARE plan covers ambulance services in these situations.

“TRICARE covers ambulance services when medically necessary, based on the condition of the beneficiary receiving the service,” said Elan Green, chief of TRICARE Health Plan’s Medical Benefit and Reimbursement Section at the Defense Health Agency. “It’s good to know how TRICARE covers these services before you have an emergency. This can help you avoid surprise costs.”

If you have TRICARE For Life, you must follow Medicare’s rules for ambulance services. This doesn’t apply if you live outside the United States and U.S. territories. For other plans, read on to learn how TRICARE covers ambulance services.

Outpatient and inpatient ambulance services
Your location plays a role in the type of ambulance service you receive.

Outpatient ambulance service happens when an ambulance takes you from your home, an accident scene, or another location to a hospital.

Inpatient ambulance service happens when an ambulance takes you from one hospital to a hospital more capable of providing the care you need.

These services have out-of-pocket costs based on:
• Your TRICARE plan
• Your beneficiary group
• Whether you go to a network hospital or a non-network hospital
• Whether the ambulance service is inpatient or outpatient

You can find these costs with the Compare Costs tool. Call your regional contractor to learn more.

Treat-and-release service
Treat-and-release service is when an ambulance treats you for an emergency but doesn’t take you to a hospital. TRICARE covers treat-and-release when:
• The services you receive are medically necessary.
• You don’t need to go to a hospital.
• You refuse transport after being treated.

Air and boat evacuation
Emergency transport by air or boat may be medically necessary. TRICARE covers air or boat evacuation only if:
• A regular “land” ambulance can’t get to you.
• The nearest facility is far away or there are other obstacles.
• You must be seen quickly for your medical condition.
• You can’t safely get the care you need in your location.
• You’re taken to the nearest hospital with appropriate facilities.

Ambulance services overseas
The TRICARE Overseas contractor, International SOS, provides 24/7 support if you need emergency care. Call International SOS to confirm your coverage before you receive ambulance transport. On the Contact Us page, choose where you’re located to see a list of contact numbers, including Medical Assistance numbers. As noted in the TRICARE Overseas Program Handbook, you should only call Medical Assistance numbers to coordinate emergency care.

Limitations
TRICARE doesn’t cover ambulance services that aren’t medically necessary. To learn more about what TRICARE covers, check out Ambulance Services.

Remember, if you have a medical emergency, call 911 or visit the nearest emergency room.

• Date Taken: 01.17.2024
• Date Posted: 01.17.2024 14:12
• Story ID: 461961
• Location: FALLS CHURCH, VA, US