The answer is – it depends.
If there is an emergency and you are unable to express your wishes, even if you have advanced medical directives or a health care proxy in place, the Emergency Medical Technicians or Paramedics responding to the call are obligated to stabilize you and transport you to the nearest appropriate hospital. This does not necessarily mean you’ll be transported the closest hospital – for example, if you are severely burned, the ambulance may bring you to the nearest hospital with a specialized burn unit, even if there are other hospitals closer by. Once you have been evaluated, your advanced health care directives can be implemented, including transporting you to another hospital if a transport can be done safely.
In a situation where you are able to express your wishes, an ambulance may take you to the specific hospital you demand. Some ambulances, especially town or municipal ones, may be assigned to a certain “zone,” and are unable to take you to a hospital outside of their assigned region. And, if a hospital’s emergency room is full and not accepting any more patients, an ambulance may not be able to bring you there, even if that is where you wish to go.
It is also important to note that Medicare only covers ambulance services “to the nearest appropriate medical facility that’s able to give you the care you need.” If you demand transportation and are brought to another hospital instead of a closer, equivalent facility, you could be left to foot the bill on your own. An ambulance crew cannot ask you about your insurance, but it is important to know that Medicare may not cover ambulance transport if you demand a specific hospital.