Ambulance Services – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers emergency air when ground transport is impractical or would dangerously delay care, emergency ground to the nearest appropriate acute or neonatal facility when delay would endanger life (including on‑scene treatment), and certain non‑emergency interfacility transfers when required services aren’t available at the origin; excluded are non‑ambulance modes (commercial/private air, taxis, rideshares, vans), transports to homes/residential/custodial facilities, services by unlicensed providers, convenience transports, and any transport not meeting the policy’s clinical criteria. Key requirements: medical record documentation demonstrating medical necessity (need for ALS/BLS, inability to safely use ground, nearest capable facility), prior authorization for non‑emergency air (and plan‑dependent non‑emergency ground), proper licensing, and correct billing modifiers per the member’s benefit plan.

"Emergency Air Ambulance services are considered Medically Necessary when all of the following criteria are present:"