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Do Medicare Plans Cover Transportation for Medical Reasons?

Getting transportation to and from your medical appointments can be challenging. Medicare covers some of the costs of emergency ambulance transportation. But when it comes to scheduled, non-emergency transportation — like going to your doctor’s office, pharmacy, or physical therapy — coverage gaps exist, which means you may have to pay out of pocket. Knowing what Medicare does and doesn't cover regarding transportation can help you prepare for the care you need.

Key takeaways:

Does Original Medicare cover transportation for medical reasons?

Medicare Part B helps pay for ambulance transportation in emergencies. If you have a health problem that requires an ambulance to get to or from the hospital, a critical access hospital (CAH), a rural emergency hospital (REH), or a skilled nursing facility (SNF), Medicare will cover some of the cost. This includes ground and air ambulances if medically necessary. You will be responsible for paying your Medicare Part B deductible and 20% co-insurance.

However, Medicare does not cover transportation costs for regular medical appointments. Non-emergency ambulance trips are also generally excluded, but exceptions exist.

For example, you might be eligible for a non-emergency ambulance ride if it's necessary for your health condition, and using another type of transportation could be risky for your health. In these non-emergency cases, Medicare will pay for limited ambulance trips if two things happen:

  • Your healthcare provider writes you a letter verifying that ambulance transportation is medically necessary.
  • The trips are to a place Medicare covers, like a hospital or medical clinic.

An example of a non-emergency ambulance transport that Medicare may cover is dialysis treatments. If you have permanent kidney failure called End-Stage Renal Disease (ESRD), Medicare may help pay for some ambulance trips to your dialysis appointments.

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What is non-emergency medical transportation (NEMT)?

Non-emergency medical transportation (NEMT) refers to travel to scheduled medical appointments and other healthcare facilities when there is no health emergency.

Some examples of NEMT include:

  • Transportation to dialysis treatments.
  • Rides to physical therapy or chemotherapy sessions.
  • Van rides to your primary care physician or specialist for checkups.
  • Travel to and from the pharmacy to pick up prescriptions.
  • Transportation to and from outpatient rehabilitation clinics.

NEMT does not include ambulance trips during medical emergencies like heart attacks, accidents, or critical injuries or illnesses.

If you receive non-emergency medical transportation by ambulance, the ambulance company should give you an Advance Beneficiary Notice of Noncoverage (ABN) if they think Medicare may not cover that ride.

To get information on how to schedule a non-emergency medical transportation with Medicare, call 1-800-633-4227. If you use a TTY, call 1-877-486-2048.

When do I need transportation prior authorization from Medicare?

If you use a scheduled, non-emergency ambulance for three or more round trips within 10 days or at least once a week for three weeks or more, you might need to obtain prior authorization from Medicare.

This means the ambulance company will ask Medicare for permission before providing your 4th round trip ambulance ride for non-emergency medical transportation. This helps you and the company know early on if Medicare will cover the transportation cost. You or the ambulance company can ask for this prior approval.

If Medicare approves the prior authorization request, they will pay for your ambulance trips as long as the ambulance provider gets a written order from your healthcare provider saying the transportation is medically needed.

If Medicare doesn't approve the request, you can appeal the decision. If you still use repeated non-emergency ambulance services without Medicare’s prior authorization, Medicare won't cover the expenses, and the ambulance company may bill you for all the charges.

Do Medicare Advantage plans cover transportation?

Medicare Advantage (MA) plans, or Medicare Part C, cover emergency ambulance transportation like Original Medicare.

Many MA plans — especially those providing Special Needs Plans — offer coverage for non-emergency medical transportation, but the specifics can vary between plans. For example, several MA plans reimburse you when you take public transportation to your medical appointments, like buses or subways. Others will schedule and pay for trips through rideshare services like Uber or Lyft.

If transportation to your medical care is a concern, check plan details closely when comparing Medicare Advantage options in your state and county before enrolling.

What non-Medicare transportation options might be available?

If your Medicare plan does not cover transportation for your medical care, several programs and services outside of Medicare may assist with free or discounted rides.

Medicaid

Some state Medicaid programs have non-emergency medical transportation benefits. Eligible members can access assistance getting to health services via taxis, Uber, Lyft, or other means with all or part of the costs covered. Check if your state Medicaid agency includes this if you qualify for Medicaid.

Public transit

Many cities and towns have bus or subway systems with accessible or paratransit services. These tend to have discounted fares for older adults and riders with disabilities. Check your local public transit website for routes to medical centers and any special programs.

Private shuttle services

Some hospitals, clinics, pharmacies, and health centers run free or low-cost shuttle vans on dedicated routes to and from their facilities. These transportation services make stops to pick up patients and families for appointments. Check facilities in your area to see if they offer shuttle services.

Social services agencies

Contact your county or city social services department to ask about medical transportation programs. Some have voucher systems to reimburse mileage or taxi rides for qualifying people traveling to covered care.

Advocacy groups

Organizations like the National Aging and Disability Transportation Center help advocate for and locate transportation solutions for older adults and those with impairment issues. They have experts familiar with free or affordable transportation programs in your area. Call them at 1-866-983-3222.

Online ride locators

Websites like the Eldercare Locator or Rides in Sight allow you to enter your zip code and get connected with local transportation assistance programs for medical trips. These local agencies assist with arranging discounted or volunteer-based rides for older adults needing medical access.

State Health Insurance Assistance Program (SHIP)

SHIPs provide free Medicare counseling and assistance. Counselors can help you understand Medicare transportation benefits and find programs offering free or discounted transportation.

Both Original Medicare and Medicare Advantage plans cover ambulance transportation in an emergency. But, coverage varies widely for non-emergency transportation needs.

Original Medicare may pay for non-emergency ambulance rides if your healthcare provider confirms they’re medically necessary for health reasons. Medicare Advantage plans often cover more routine transportation beyond ambulances.

There are free or discounted non-Medicare transportation options available. Look into Medicaid if you qualify. Public transit, advocacy groups, and online ride locators are also alternatives.

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