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We had to call the paramedics a few weeks ago because my mom was lying on the floor and couldn't get up.
I tried very hard to talk with her but she wouldn't get up so we called paramedics. They came and did some simple steps. She got up okay. The whole thing was like 15 minutes.
They sent a form to me and I entered the insurance info, which was Medicare and other insurance. Then they called me and said this type of service is not covered by either insurance because they didn't take her to a hospital. I guess we have to pay.
Location: East of Seattle since 1992, 615' Elevation, Zone 8b - originally from SF Bay Area
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Was this an ambulance company? Usually the fire department would do this service and not charge for it, I know here that is free. Ambulance companies charge for the visit and the transport, if any. Medicare part B pays for paramedic/ambulance but only under certain circumstances. If they feel that it was inappropriate for the circumstances, they won't pay. I would bet that in this case since she was not transported, it didn't require paramedics. When my (late) mother-in-law fell and couldn't get up, she had a couple of injuries and was transported to the ER, and Medicare picked that up.
You'll probably have to pay, BUT I would call and discuss it with both Medicare and the other insurance, as sometimes, it takes a little effort to get an insurance company to pay. At the very least, you'll understand how it works in the future, should something similar happen.
Was this an ambulance company? Usually the fire department would do this service and not charge for it, I know here that is free. Ambulance companies charge for the visit and the transport, if any. Medicare part B pays for paramedic/ambulance but only under certain circumstances.
Where I live, the city fire department also provides EMS & ambulance transport, but I know they do charge for medical response. However, it is essentially a "non-profit" local government operation, and although I don't know what the current fees are, the last time I checked, emergency medical response with no transport to an ER, resulted in only a nominal fee.
In a situation where someone has fallen but couldn't get up on their own, but didn't otherwise exhibit any medical symptoms or signs of injury, insurance may deny a claim, as there was no actual medical issue.
Location: East of Seattle since 1992, 615' Elevation, Zone 8b - originally from SF Bay Area
44,551 posts, read 81,085,957 times
Reputation: 57734
Quote:
Originally Posted by ged_782
Where I live, the city fire department also provides EMS & ambulance transport, but I know they do charge for medical response. However, it is essentially a "non-profit" local government operation, and although I don't know what the current fees are, the last time I checked, emergency medical response with no transport to an ER, resulted in only a nominal fee.
In a situation where someone has fallen but couldn't get up on their own, but didn't otherwise exhibit any medical symptoms or signs of injury, insurance may deny a claim, as there was no actual medical issue.
Interesting, another city near us charges too, but the Fire District we are in doesn't charge for anything. We pay for it through our (high) property taxes.
In a situation where someone has fallen but couldn't get up on their own, but didn't otherwise exhibit any medical symptoms or signs of injury, insurance may deny a claim, as there was no actual medical issue.
In terms of health insurance coverage, this is probably important...no actual medical care was provided.
My elderly dad called 911 when he couldn't get back on his feet after losing his balance during a nighttime bathroom visit. No contributing medical issue, no injury, treatment or transport. Fire department/EMTs responded. He received a bill for the call. Insurance didn't cover it.
Forewarned is forearmed OP. Agree that you should look into how emergency response in your area works and what if anything your current health insurance would pay for.
Last edited by Parnassia; 02-14-2024 at 04:48 PM..
I always heard the fire dept would do this for free. I lived in a place with a regional ambulance service, that quite often came by for my elderly landlord. I asked them once if they charged money for "house calls"; the answer was No, only if they transported you to the hospital.
What bothers me is that I asked the paramedics if we would be charged and he said "no." I even offered my mom's medicare card number and they said not to show it.
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