Original Medicare (Parts A & B): Emergency Department Services

Emergencies are occurrences that require immediate and complex medical attention (this benefit does not include ambulance services).

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Cost
Copay for each emergency department visit; 20% of the Medicare-approved amount for provider services; Part B deductible applies
Prior Authorization Required
No
Provider Referral or Order Required
No

How To Receive

Details on how to apply

In the event of an emergency, get your loved one to the nearest appropriate emergency department. Do not hesitate to call 9-1-1 for ambulance transport, if needed.

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Note that if the provider admits your loved one to the same hospital as an inpatient, costs may be different.

For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.

Availability
Ongoing
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A medical emergency is when you, your loved one, or any other prudent layperson with an average knowledge of health and medicine, believes that medical symptoms require immediate medical attention to prevent devastating illness, loss of life, loss of a limb, or loss of function of a limb.

The medical symptoms may be significant illness, injury, severe pain (including any unexplained or uncontrolled chest pain), or a medical condition that is rapidly getting worse.

Emergency care is services that are needed to evaluate, treat, and/or stabilize an emergency medical condition and are rendered by a provider qualified to furnish emergency services.

This benefit does not include ambulance services (see Ambulance Services benefit).

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