Ambulance and Transport Services

Covers ambulance and transport services—including emergency ground and medically necessary air ambulance—for patients with sudden or significantly worsening, potentially life‑threatening conditions (e.g., intracranial bleeding, acute MI, cardiogenic shock, life‑threatening trauma, severe burns, transplant transfers, high‑risk pregnancy, unstable vital signs) when other transport is medically contraindicated. Coverage is limited to medically necessary transfers to the nearest appropriate facility and is subject to member benefit plans and state rules; air transport requires that ground transport would threaten survival or that air achieves substantial time savings, non‑emergency/convenience transports and transfers not meeting all criteria are not covered, and the policy is inactive for dates of service on/after 2026‑01‑01 (see superseding policy MED201.058).

"Emergency ambulance transport for sudden onset or significant worsening of a medical condition with symptoms of sufficient severity that, absent immediate transport, a prudent layperson would reaso..."