“Appropriate Facility” for Medical Air Transportation According to Medicare

Among the many conditions Medicare lays down, ensuring that “the facility is appropriate” is vital. Failing this condition, the medical air transportation service might go uncovered and cause financial stress on you later. Here, we try and understand what makes a medical facility appropriate. The data has been collected from Department of Health and Human Resources, Centers for Medicare and Medicaid Services.

The Medical Air Transportation Must Carry the Patient to an Equipped Facility

The appropriate facility could be an acute care hospital. The facility must be adequately equipped to provide hospital care or skilled nursing services which are in accordance with the demands of the injury or illness that the patient comes with. A physician or specialist who is qualified to take care of the patient must also be available at the destination that the medical air transportation carries him or her to.

Situations that Allow Medical Air Transportation to a More Distant Facility

It is generally assumed that all licensed medical facilities would be able to care for the patient. If the nearest medical facility is not equipped enough to care for the patient, medical air transportation of the patient can be carried out to the next nearest facility. The circumstances that warrant such medical air transportation are as follows:

  • The patient’s condition demands a higher level speciality or trauma care, which can only be availed at a medical facility that is more distant.
  • There is a problem with the availability of beds in the nearest facility.

The medical air transportation to a facility solely for the purpose of availing the service of a particular doctor is not permissible and might not be covered. Also, Medicare might not cover medical air transportation to a distant hospital merely because the patient desires it, in spite of the medical facilities being available at the nearest hospital.

Unless you are ready to bear the cost of medical air transportation yourself or have other means to cover the cost, these facts must be borne in mind. Knowing such conditions beforehand keeps you insulated from monetary shocks at a later stage.

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