Medicare Advantage Ground Ambulance Cost Sharing Levels Strain Enrollees and Ground Ambulance Entities
October 31, 2025
This white paper presents findings from Health Management Associates’ (HMA) 2025 analysis of state-level variation in MA plan copayments for ground ambulance transports. We identify the range of cost sharing used by MA plans by state, the average MA plan copayment by state, and compare these average copayment levels to both national Medicare FFS cost sharing levels for ground ambulance services. The report also examines average state-level MA plan copayment levels for emergency department services.
As our analysis demonstrates, the flexibility permitted to MA plans to establish beneficiary cost sharing levels for ground ambulance services has resulted in wide variation in MA plan copayments and significantly higher cost sharing for ground ambulance services for MA beneficiaries than those enrolled in traditional Medicare. The flexibility of the MA benefit design for ground ambulance services has potentially negative consequences for the millions of MA plan enrollees and the roughly 11,000 ambulance entities which conduct these services and collect beneficiary cost sharing.
