I took an ambulance to the emergency room after I had a fall at home and just received a bill from the ambulance company. Does Medicare cover ambulance rides?

Medicare covers emergency ambulance services and, in certain limited situations, nonemergency ambulance services. However, Medicare will only cover ambulance services when they are deemed medically necessary and reasonable. Here are some useful details to know about Medicare’s transportation coverage.

“Medically necessary” 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 can receive care that Medicare covers. If a car or taxi could transport you without endangering your health, Medicare will not pay. For example, Medicare will likely not pay for an ambulance to take someone with an arm fracture to a hospital. But if the patient goes into shock, or is prone to internal bleeding, an ambulance transport may be medically necessary to ensure their safety on the way.

The ambulance must take you to the nearest appropriate medical facility. If you choose to be transported to a facility located farther away because the doctor you prefer has staff privileges there, expect to pay a greater share of the bill. Medicare will only cover the cost of ambulance transport to the nearest appropriate facility.

Medicare may also pay for an emergency flight by plane or helicopter to the nearest appropriate medical center if the trip takes too long on the ground and would potentially endanger your health.

Nonemergency Situations

Medicare may also cover ambulance transportation in some cases when you are not facing a medical emergency. To receive this coverage, your doctor must provide an order stating that an ambulance is medically necessary because other forms of transportation could endanger your health. For example, if you have been diagnosed with end-stage renal disease, Medicare may cover the ambulance trips to and from a dialysis center if you have a doctor’s order that certifies that this mode of transportation is required for your safety.

You also need to know that, in nonemergency situations, ambulance companies are required to give you an Advance Beneficiary Notice (ABN) if they believe Medicare may not pay. An ABN notifies you that you will be responsible for paying if Medicare denies coverage.

Ambulance Costs

Ambulance rides can vary from several hundred to several thousand dollars depending on where you live and how far you are transported. Medicare Part B pays 80% of the Medicare-approved ambulance rides after you have met your annual Part B deductible ($257 in 2025). You or your Medicare supplemental policy (if you have one), are responsible for the remaining 20%.

If you have a Medicare Advantage Plan, it must cover the same services as original Medicare, but it may offer additional transportation services. You will 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. To appeal, visit Medicare.gov, click on “Providers & Services” followed by “Claims, Appeals, & Complaints.” To help with your case, ask the doctor who treated you for documentation specifying that you required an ambulance.

If you need help filing an appeal, contact your State Health Insurance Assistance Program (SHIP) for assistance. Visit ShipHelp.org or call 877-839-2675 for contact information on your local SHIP provider.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of “The Savvy Senior” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

The Internal Revenue Service (IRS) and Security Summit partners published a guide this week identity theft protection. The IRS and Security Summit recommends multifactor authentication and Identity Protection PINs. The IRS offers taxpayers the ability to create an IRS Online Account and a Tax Pro account for tax professionals.

1. Multifactor Authentication — Your primary protection involves multifactor authentication for accessing an account. The Federal Trade Commission (FTC) requires tax professionals to use multifactor authentication to protect their clients. The multifactor authentication may be a code number sent to your cell phone or a similar authentication factor sent to your email address. In addition to multifactor authentication, you should always protect your username and password to all accounts. Multifactor authentication enhances security, as it reduces the ability of identity thieves to use phishing or social engineering to steal passwords or personal information. Many organizations now offer an option for you to select a code sent to your phone or an email address. This places the user in control of multifactor authentication.
2. Identity Protection (IP) PIN — An IP PIN is a six-digit number. For most taxpayers, it is voluntary but strongly recommended. You should protect your IP PIN and reveal it only to a trusted tax preparer. The IRS reminds taxpayers that they will not call, email or text a request an IP PIN. If you receive a call, email or text request for your IP PIN, it is likely a fraudulent request. The IP PIN is valid for one calendar year. You may obtain it on the IRS website by visiting the \"Get an IP PIN” webpage. If you are a victim of identity theft, the IRS will automatically issue an IP PIN to you each year.
3. IRS Online Account — The IRS encourages taxpayers to establish an IRS Online Account. Your online account provides access to your tax information. It also reduces the ability of fraudsters to create a false account and claim your identity. Your account also enables you to share information with your trusted tax professional.
4. Tax Professional Account — The IRS allows tax professionals to create an account to manage their client authorizations. With the account and permission from the client, the tax professional may send requests to a taxpayer\'s IRS Online Account. It also enables the tax preparer to obtain authorized information from clients.

The Security Summit conducts a summer series annually to educate taxpayers and tax professionals. Nationwide Tax Forums for tax professionals will be held in five cities this year. Information on the Tax Forums is available on IRS.gov.

What is the best way to find a good maintenance or repair person that can help with small jobs around the house?

Finding a good repairer can be a bit of a challenge. How do you find someone who will return your calls or texts, show up on time, do the job right and finish it, all at a fair price? Here are a few tips and resources that can help you with your search.

What Kind of Help

While it may seem obvious, whom you call on for help will depend on what you need done. For example, if you have an odd job or small home repair project that does not require a lot of technical expertise, a repair person may be all you need. But if you have a job that involves electricity, plumbing, heating or cooling systems, you are better off hiring a licensed tradesperson. Bigger jobs like home renovations or remodeling may require a general contractor.

Where to Find Help

One of the most reliable ways to find help is through referrals from people you trust. If your friends or family do not have any recommendations, turn to professionals in the field like a local hardware or home improvement store, or real estate agents. If you do not have any luck in this search, there are a number of online resources you can turn to that can quickly connect you to a wide variety of skilled workers in your area.

If you are looking for someone to do a home chore or a small job, an option is to use online platforms that connect you with freelance workers who have undergone background checks. On these sites, you can find help with tasks like furniture assembly, lifting or moving heavy items, mounting TVs or shelves, making minor home repairs and indoor and outdoor cleaning services. Freelance workers set their hourly rates, which are typically displayed on these websites for your review before you book an appointment.

Other good options for locating repair people are fix-it franchises or repair service companies. These companies vet and insure their staff, but they may be more expensive than hiring an individual directly. You may also consider using social networking sites to ask for recommendations.

If you are in the market for a specialist, like a plumber, electrician, painter, roofer or carpenter, there are also websites that connect you with licensed contractors. These websites also vet their independent contractors and will let you request quotes from several candidates. Depending on the website you choose, some may offer more details like average response time, specifics about the work they do and photos of past projects. To find these websites, use your preferred online search engine and search using terms like “how to find a home repair person” or “licensed contractors near me.”

Things to Know 

Once you have located a few candidates, here are some steps you can take to protect yourself and ensure you are satisfied with the results. Get a handwritten estimate or digital contract that lists the tasks and the hourly rate or project fee. Next, ask to see their proof of insurance, which will cover any damages they may cause while working on your home. Also, consider asking for several references from past jobs.

It is best to pay only after the work is complete, though it is not unusual to be asked for a small deposit for material costs upfront. Whenever possible, you should pay with a credit card, since it offers the ability to dispute the payment if something goes wrong with the job. Checks and electronic payments do not offer the same level of protection.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of “The Savvy Senior” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

What can you tell me about restless leg syndrome? Over the past year, I have developed an uncontrollable urge to move my legs because of a tingling sensation, and it is keeping me awake at night.

If an irresistible urge to move your legs has you kicking in your sleep, you may be dealing with symptoms commonly associated with restless leg syndrome (RLS), a condition that affects about 7% to 8% of Americans. Here is what you should know.

RLS, also known as Willis-Ekbom Disease, is a nervous system problem that causes unpleasant or uncomfortable sensations such as crawling, tingling, itching, aching, throbbing, pulling or an electric feeling in one or both legs. These sensations create an urge to move your legs when you are sitting or lying down, and the symptoms usually get worse with age. It typically happens in the evenings or at night while resting. Moving eases the unpleasant feeling temporarily.

While RLS is not a life-threatening condition, it disrupts sleep which can lead to daytime drowsiness, difficulty concentrating and possibly depression. The cause of RLS is unknown. Researchers suspect it could be linked to several things including iron deficiency or an imbalance of the brain chemical dopamine. There is also likely a genetic component since about 60% of people with RLS have a family member with the same condition.

Treatments

While there is no cure for RLS, there are things you can do to help alleviate the symptoms. The first line of defense is usually to avoid certain substances like alcohol, caffeine, nicotine and refined sugar, which can aggravate the problem.

Some drugs including antinausea drugs, some antidepressants and cold and allergy medications containing sedating antihistamines can also worsen RLS symptoms. If you take any of these medications, ask your doctor or pharmacist if something else can be taken.

Iron and magnesium deficiencies are also believed to be contributors to RLS. It may be wise to make an appointment with your doctor and get a blood test to check for this. If you test positive for iron or magnesium deficiency, your doctor may recommend supplements.

You may also benefit from self-care treatments such as leg or calf stretches and massage, hot baths or applying hot or cold packs to the affected area. Pressure can also be effective for some people, so wearing compression socks may be helpful.

Getting moderate, regular exercise like walking, cycling, water aerobics and yoga may help ease symptoms. However, exercising too intensely or exercising late in the day may intensify RLS symptoms.

Medications

If the previously listed tips and self-treatments do not reduce your RLS, there are various medications your doctor can prescribe that can help, including:

Anti-seizure drugs: These medications affect nerve cell activity to reduce symptoms. Examples include gabapentin enacarbil, gabapentin and pregabalin.

Dopaminergic medications: These drugs, which are taken before bedtime, work by increasing dopamine, a chemical in the brain that helps reduce RLS symptoms. Examples are ropinirole, pramipexole and the transdermal patch rotigotine. Be aware that while these drugs, taken short-term are effective, long-term use can make symptoms worse.

Anti-seizure medicines are a popular treatment option because they seem to be as effective as dopaminergic medications, with fewer side effects. Sometimes, other medications like benzodiazepines – alprazolam, clonazepam, diazepam – may be prescribed for more restful sleep, but they do not eliminate the leg sensations, and they can be addictive, so it is best to avoid them if possible. For more information, visit the Restless Legs Syndrome Foundation at RLS.org.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of “The Savvy Senior” book.  Any links in this article are offered as a service and there is no endorsement of any product.  These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics.  Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.