You might require non-emergency transportation for a variety of reasons – but will Medicare cover it?
As we get older, our access to transportation often decreases. This can, understandably, be upsetting; reliable transportation is how we navigate most of life, from seeing friends and family to ensuring we get medical care. Thankfully, Medicare beneficiaries with limited access to transportation do have options when it comes to making sure they get medical care.
When does Medicare cover transportation?
While Original Medicare (Part A and Part B) does not cover non-emergency medical transportation, such as to routine health appointments, it does cover emergency ambulance transport.
Emergency medical transportation is covered by Medicare Part B for those who need to get to a critical access hospital, hospital, or skilled nursing facility. For Medicare to cover the ride, the services must be necessary for a medical emergency (such as a heart attack), in which immediate medical attention is necessary and/or because driving yourself to the hospital would present a safety issue. Part B may also cover emergency aerial transportation in more dire situations.
Beneficiaries pay 20% of the Medicare-approved amount for ambulance services. The Part B deductible, which is $164.90 in 2023, does apply.
Although Original Medicare does not cover non-emergency transportation, it may cover medically necessary transportation in non-emergency situations. To be covered, you would need a note from your doctor confirming it is medically necessary, such as an End-Stage Renal Disease (ESRD) patient getting an ambulance ride to a hospital for dialysis. Medicare Part B only covers non-emergency transport to the nearest medical facility.
Does Medicare Advantage cover transportation?
Federal law requires Medicare Advantage plans, or Medicare Part C, to offer the same level of coverage as Original Medicare. But most plans also include a multitude of additional benefits, the most common of which are prescription, fitness, dental, hearing, and vision coverage.
Part C plans are sold by private insurers, so plan options and costs vary. Some Advantage plans do cover non-emergency transportation, but if that is a service you require, you need to make sure the plan you are looking at includes it.
The quickest, easiest way to find a Medicare Advantage plan is with our Find a Plan tool. Just enter your zip code and you'll be browsing Medicare plans in your area in no time. To find a plan that includes non-emergency transportation, look at the benefits.
You can also call us toll-free at 888-992-0738 to speak to a licensed, knowledgeable representative.
Do Medigap plans cover transportation?
Medicare Supplement Insurance, also known as Medigap, helps cover some of your costs associated with Original Medicare. They do not, however, provide additional benefits. Instead, Medigap plans pay some – or all – of your out-of-pocket costs.
How much is covered depends on which plan you choose, but every plan gives you an additional 365 lifetime reserve days for inpatient care and also covers your Part A coinsurance. (Part A is what applies for inpatient care.)
Medigap plans only cover the same services as Original Medicare. So, a supplement plan would not directly cover any transportation. But it may step in to cover your coinsurance and deductible if you’re admitted to the hospital.
Like Advantage plans, Supplement insurance is sold through private insurers, so your cost and coverage options vary – although the plans are standardized, so every Medigap Plan A (or B, C, etc.) provides the same benefits as every other Plan A (or B, C, etc.). The main differences you’ll see are in premiums, which vary widely according to where you live and which provider you choose.
Learn about what each Medigap plan covers here.
Please note that you cannot have both a Medigap plan and a Medicare Advantage plan.
Does Medicaid cover transportation?
Though Medicaid coverage varies from state to state, there are some things that it is required to cover by federal law, one of which is emergency medical transportation.
Some state Medicaid programs also cover transport to regular health appointments at a clinic or doctor's office. To qualify for Non-Emergency Medical Transportation (NEMT), you must meet certain criteria, which can include:
- An inability to travel or wait for rides alone
- Physical or mental disability
- No driver's license
- No vehicle or an inoperable vehicle
The rules for NEMT depend on the state you live in, with some states requiring prior authorization or other limitations. The best way to see if your state covers non-emergency medical transportation is to check with your specific Medicaid program.
If you need transportation but do not have the coverage for it, you still have options. Start by calling your medical provider. Many clinics and medical facilities have their own form of transportation or shuttle to help patients get to and from appointments,
You can also look into the following:
Programs of All-Inclusive Care for the Elderly
Programs of All-Inclusive Care for the Elderly, or PACE, is a program run by both Medicare and Medicaid. PACE benefits include services from both programs, as well as many other benefits, including but not limited to:
- Social services
- Physical therapy
- Prescription drugs
It also includes all services determined necessary to maintain a patient's health. If you are eligible for the program, an interdisciplinary team works to coordinate your medical care, which includes a driver.
Though not often thought of when it comes to healthcare needs, rideshare services are a valuable solution for medical transportation. While the standard services are already a viable option, some companies now have rideshare services geared specifically towards medical transportation.
In 2021, Lyft announced a new product called Lyft Pass for Healthcare, created specifically for getting people to and from health appointments. There is also Uber Health, which helps people book rides for healthcare services without having to actually make an account through the Uber app.
With a bit of research, you can find a safe way to get to your doctor appointments.
- ClearMatch Medicare: Find a Medicare Plan
- Medicaid.gov: Beneficiary Resources
- Medicaid: Programs of All-Inclusive Care for the Elderly Benefits
- Net Solutions: 10 Best Rideshare Apps