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THE SAUGUS ADVOCATE – Friday, August 9, 2019 Page 19 S by Jim Miller How Medicare Covers Ambulance Services Dear Savvy Senior, How does Medicare cover ambulance services? About three months ago, I took an ambulance to the hospital emergency room because I rarely drive anymore, and I just received a $1,100 bill from the ambulance company. Surprised Senior Dear Surprised, This is a Medicare issue that confuses many seniors. Yes, Medicare does covers emergency ambulance services and, in limited cases, non-emergency ambulance services too, but only when they’re deemed medically necessary and reasonable. So, what does that means? First, it means that your medical condition must be serious enough that you need an ambulance to transport you safely to a hospital or other facility where you receive care that Medicare covers. If a car or taxi could transport you without endangering your health, Medicare won’t pay. For example, Medicare probably won’t pay for an ambulance to take someone with a simple arm fracture to a hospital. But if he or she goes into shock, or is prone to internal bleeding, ambulance transport may be medically necessary to ensure the patient’s safety on the way. The details make a difference. Second, the ambulance must take you to the nearest appropriate facility, meaning the closest hospital, critical access hospital, skilled nursing facility or dialysis facility generally equipped to provide the services your illness or injury requires. It also means that the facility must have a physician or physician specialist available to treat your condition. Thus, Medicare may pay for an ambulance to take you to a more distant hospital if, for example, you are seriously burned, and the nearest hospital doesn’t have burn unit. Similarly, if you live in a rural area where the nearest hospital equipped to treat you is a two-hour drive away, Medicare will pay. But if you want an ambulance to take you to a more distant hospital because the doctor you prefer has staff privileges there, expect to pay a greater share of the bill. Medicare will cover the cost of ambulance transport to the nearest appropriate facility and no more. Non-Emergency Situations In limited cases, Medicare will also cover non-emergency ambulance services if such transportation is needed to treat or diagnose your health condition and the use of any other transportation method could endanger your health. Not having another means of transportation is not sufficient for Medicare to pay for services. Some examples here are if you need transportation to get dialysis or if you are staying in a skilled nursing facility and require medical care. In these cases, a doctor’s order may be required to prove that use of an ambulance is medically necessary. Ambulance Costs The cost for ambulance services can vary from several hundred to several thousand dollars depending on where you live and how far you’re transported. Under original Medicare, Part B pays 80 percent of the Medicare-approved amounts for ambulance rides. You, or your Medicare supplemental policy (if you have one), will need to pay the remaining 20 percent. If you have a Medicare Advantage Plan, it must cover the same services as original Medicare, and may offer some additional transportation services. You’ll need to check with your plan for details. How to Appeal If an ambulance company bills you for services after Medicare denies payment, but you think the ride was medically necessary, you can appeal (see Medicare.gov/claims-appeals). Often, a lack of information about a person’s condition or need for services leads to denials. If you need some help contact your State Health Insurance Assistance Program (SHIP), which has counselors that can help you file an appeal for free. To locate your local SHIP, visit ShiptaCenter. org or call 877-839-2675. For more information on this topic, call Medicare at 800-6334227 and ask them to mail you a copy of the “Medicare Coverage of Ambulance Services” booklet, or you can see it online at Medicare.gov/Pubs/pdf/11021-Medicare-Coverage-of-AmbulanceServices.pdf. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. Obituaries Lori Jean (Nelson) Harring A ge 58, died suddenly a t home on Monday, July 29, 2019. Lori was born on August 14, 1960 in Saugus to Arnold Harvey Nelson and Eleanor (Wheeler) Nelson. Lori was a graduate of Saugus High School, Class of 1978. During her youth, she was a proud member of the Saugus Socialites and performed competitively, and in parades as a drummer for many years. She worked for the past 14 years at Peter Condakes Company, Inc. in Chelsea. Lori was a lifelong resident of Saugus where she met and married her adoring husband, Michael Harring, on May 14, 1983. The couple has spent over 40 years together. They resided in Saugus where they raised their children and were surrounded by close family. Lori truly lived life to the fullest through simple pleasures; like spending time with her family and friends, gardening in her beautiful yard, making exquisite crafts, caring for her pets, cooking for a only a few or for her large extended family on holidays. Lori had a way to make even strangers feel welcome in her home. Lori loved to vacation in the mountains by a lake, and sitting by a campfire. She also loved to travel to places like Hawaii, Florida or on a Caribbean cruise. Lori was adored by all who knew her. Lori is survived by her devoted husband Mike; their children, Jessica and Jason Harring, her brother, Stephen Nelson and his wife Wendy; her loving sister and best friend, Marjorie Nelson; her niece Nicole (Nelson) Taylor, her husband Matthew, her nephews, Adam Nelson, Eric Nelson, his wife Chelsea (Emmons), Brian Nelson, Drew Nelson, her great nephew Nolan Taylor and greatniece Kennedi Nelson. She is also survived by many aunts, uncles and very special cousins. In lieu of flowers, friends and family may make a contribution to the American Heart Association. https://www.heart.org/en/ get-involved/ways-to-give. Joan E. (Esposito) Nicholson O f Na - ples, FL., f or mer ly of Saugus, age 81, died on Monday, July 29 at Massachusetts General Hospital in Boston. She was the wife of the late George W. Nicholson. Born in Winthrop and raised in Saugus, she was the daughter of the late Nicholas and Adeline (D’Arcangelo) Esposito. A graduate of Saugus High School in 1955 she and her husband owned and operated Sanborn News & Convenience Store. They retired to Grantham, NH and then to Naples, FL where she enjoyed the beach, bocce, the pool, the sun and “Happy Hours” with friends and neighbors. Mrs. Nicholson leaves one son, Timothy Nicholson and his wife Kathy of Saugus; two daughters, Linda Nicholson and her fiancé Dick Stewart of Saugus, and Laura & Doug Nicholson of New Hampshire; and four grandchildren; Julie & her husband Kevin Moccia, Timothy, Bryant and Shelby. She is predeceased by her brother, Nicholas Esposito, and her sister, Geraldine Esposito. Barbara Ann (DiMichele) Lonergan A ge 67, died Sunday, July 28 surrounded by her family at home in Saugus. She was the wife of Dennis Lonergan, with whom she shared 43 years of marriage. Born in the North End of Boston, she was the daughter of the late Mary “Mickie” Sheehan and the late Matthew Sheehan. She attended the University of Massachusetts at Amherst, where she briefly met Julius Irving and declared him to be “very nice.” She handled financials for Meehan O & Nolan Associates for more than 20 years before retiring in 2018. Barbara was a spectacular cook, an accomplished outdoorswoman, and a fantastic dancer. With her husband, she travelled to 47 countries on five continents and made friends in every one of them. Barbara is survived by daughter Jonelle Lonergan & her husband Jared Ahern, of Stoneham. She was “Nonni” to a beloved granddaughter, Eleanor. She also leaves behind a sister, Tracy Moloney & her husband Michael, of Reading; a brother, Timothy Sheehan & his wife Janine, of Charlestown; niece Emma Moloney; and nephew Matthew Sheehan. In lieu of flowers, donations in her memory can be made to the Make-A-Wish Foundation at www.wish.org, or at 1 Bulfinch Place, Boston, MA 02114. Maria Bakopolus f Saugus, unexpectedly, July 30. Daughter of the late John & Hope (Nickole) Bakopolus. Dear sister of Anthony Bakopolus & his wife Kimberly of Saugus, Arthur Bakopolus & his wife Maria of Methuen & Heidi Pappas & her husband Peter of Saugus. Also survived by 6 nieces & nephews, Nicholas, Christopher, John, Adam, Gregory, Laura. In lieu of flowers, donations in her memory may be made to Friends of the Saugus Library, 295 Central St., Saugus, MA 01906. In Loving Memory of Paul R. Conti December 19, 1956 — August 9, 2016 The blow was great, the shock severe, We little thought the end was near. And only those who have lost can tell The pain of parting without farewell. It broke our hearts to lose you, But you did not go alone. A part of us went with you, The day God called you home. Nothing can ever take away, The love a heart holds dear. Fond memories linger every day, Rememberance keeps him Near. Always in our hearts, Love, your parents Bob and Lillian, Mary Lynn Sully, Peter, Steve, & John

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