The Medicare Insurance Lady

Celebrating since 2008 as a Medicare Insurance Specialist

(This Is NOT A Government Newsletter)

📧 tcangemi@RetirementHPMS.com

Hi there!

PERSONAL NOTE TO CLIENTS:

Time to get ready!

This is a busy time of year where I am on webinar trainings and completing recertifications with each insurance company I offer, for 2026.

I look forward to working with each of you during October 15th to December 7th. The enrollment season will be here before we know it.

MEDICARE SECTION

HOW MEDICARE COVERS AMBULANCE - Transportation

Medicare Part B covers emergency ambulance services and, in limited cases, non-emergency ambulance services. Medicare considers an emergency to be any situation when your health is in serious danger and you cannot be transported safely by other means. If your trip is scheduled when your health is not in immediate danger, it is not considered an emergency.

Eligibility:

Part B covers emergency ambulance services if:

• An ambulance is medically necessary, meaning it is the only safe way to transport you
• The reason for your trip is to receive a Medicare-covered service or to return from receiving care
• You are transported to and from certain locations, following Medicare’s coverage guidelines
• And, the transportation supplier meets Medicare ambulance requirements

To be eligible for coverage of non-emergency ambulance services, you must:

• Be confined to your bed (unable to get up from bed without help, unable to walk, and unable to sit in a chair or wheelchair)
• Or, need vital medical services during your trip that are only available in an ambulance, such as administration of medications or monitoring of vital functions

Medicare may cover unscheduled or irregular non-emergency trips, but if you live in a skilled nursing facility (SNF), a doctor’s written order may be required within 48 hours after the transport. Medicare may also cover scheduled, regular trips if the ambulance supplier receives a written order from your doctor ahead of time stating that transport is medically necessary.

Medicare never covers ambulette services. An ambulette is a wheelchair-accessible van that provides non-emergency transportation. Medicare also does not cover ambulance transportation just because you lack access to alternative transportation.

Note: If you are receiving SNF (skilled nursing facility) care under Part A, most ambulance transportation should be paid for by the SNF. The SNF should not bill Medicare for this service.

Costs:

Government or Medicare Part B covers medically necessary emergency and non-emergency ambulance services at 80% of the Medicare-approved amount. In most cases, you pay a 20% coinsurance after you meet your Part B deductible ($257 in 2025). All ambulance companies that contract with Medicare must be participating providers.

MEDICARE SECTION

PROTECT YOUR MEDICARE ID # - Medicare Scams Identified

You might have heard me explain to protect your Medicare ID# on your Medicare cards.

Your Medicare ID# is like your Social Security ID#. The same importance.

Scammers will randomly make phone calls to sell you something. These items could be durable medical equipment, covid tests, genetic testing, and more. They will tell those eligible for Medicare that Medicare will cover these items. WELL ... there is more to this story!

Medicare won’t ever call you without scheduling an appointment ahead of time, says the attached article.

It is amazing how these scammers find you. They purchase marketing lists.

“Scammers are using the COVID public health emergency, as a way to get to people,” Kinney says. “We’ve heard cases of scammers calling Medicaid beneficiaries and telling them they need to pay the [scammer] or caller so they don't lose Medicaid benefits but to also get the [beneficiaries’] personal information.”

Here are the 8 scams described in the attached article to watch out for:

1. A new round of COVID fraud

2. Bills for diabetes supplies

3. Flimsy medical equipment

4. Bogus genetic testing

5. Hospice fraud

6. Medicaid ‘unwinding’

7. Next-generation Medicare cards

8. Telemedicine sessions 

Then there are those agents/brokers who purchase marketing lists and contact the Medicare eligible population trying to get them to change their health insurance plan. You may end up changing to a Medicare insurance plan that you did not intend to enroll in.

Did you know that agents/brokers are NOT allowed to approach potential enrollees in common areas, make unsolicited phone calls (or randomly make calls), or go door to door to market to Medicare eligibles.

The CMS government rule for agents/brokers is that a Medicare eligible person needs to reach out first to a LICENSED Medicare agent/broker for help and questions. If you receive a phone call that you did not expect, hang up. A complaint can be filed also.

If you find a suspicious charge on your Summary Notice or receive a call from someone claiming to be from Medicare, you can report the suspected fraud to Medicare or call 800-633-4227.

You can also contact your state’s Senior Medicare Patrol (SMP) or call 877-808-2468. SMP volunteers can answer questions about potential scams and help you report the fraud to Medicare and the HHS Office of the Inspector General, which investigates Medicare fraud.

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