- Medicare covers some, but not all, types of medical transportation.
- Both original Medicare and Medicare Advantage cover emergency transportation by ambulance.
- While original Medicare doesn’t typically cover nonemergency transportation, some Medicare Advantage plans may offer this as an additional benefit.
- Medicaid, PACE, and other state or local programs can also help you access transportation.
Transportation is an important part of many people’s daily life. You might rely on it to commute to work, get groceries, and visit the doctor.
But as you get older, your access to transportation may become more limited. In fact, a study of nearly 7,500 Medicare beneficiaries found that about
Medicare covers some specific types of medical transportation. In this article, we’ll explore what’s covered, as well as additional resources for those on Medicare.
Original Medicare, which is made up of Medicare Part A and Part B, covers emergency transportation in an ambulance. Nonemergency transportation, on the other hand, typically isn’t covered — with a few exceptions.
Medicare Part C (Medicare Advantage) plans are offered by private health insurance companies that contract with Medicare. These plans often include benefits that original Medicare doesn’t. One potential benefit is transportation to and from doctors’ visits.
Let’s break down the types of transportation that Medicare covers in more detail.
Original Medicare, specifically Part B, covers emergency transportation in an ambulance to the nearest appropriate medical facility. This transportation is covered if you meet the following criteria:
- You need medically necessary emergency services.
- Transport in another vehicle could put your health at an increased risk.
Sometimes, ground transportation might not be an efficient way to get you the emergency treatment you need. In these cases, Part B may pay for emergency transportation by helicopter or plane.
If you need emergency transportation, you’ll pay 20 percent of the cost after you’ve met your Part B deductible. For 2020, the Part B deductible is $198.
Medicare Advantage plans provide the same basic coverage as original Medicare, including emergency transportation. But the rules or requirements for emergency transportation may vary by plan.
Medicare Part B may also cover nonemergency transportation in an ambulance. For Medicare to cover this type of service, you must have a note from your doctor stating that transportation in an ambulance is medically necessary.
The ambulance company may give you an Advance Beneficiary Notice of Noncoverage (ABN) before transporting you. You’ll received an ABN when both of the following conditions apply:
- You’re using an ambulance in a nonemergency situation.
- The ambulance company doesn’t believe that Medicare will pay for this particular ambulance trip.
When you’re given an ABN, you’ll have to decide whether you still want to use the ambulance service. If you agree to the service, you may be responsible for paying the entire cost if Medicare chooses not to cover it.
Medicare Advantage plans may cover nonemergency transportation to a doctor’s office or clinic. But this service may be covered only if it’s to a location approved by your plan. Because rules or requirements can vary, it’s important to check your specific plan to see what’s included.
In addition to the services covered by Medicare, you might have additional transportation options. Let’s explore some of them below.
Medicaid is a joint federal and state program that helps people with lower incomes pay for healthcare costs. Like Medicare, Medicaid covers the cost of emergency transportation in an ambulance.
But Medicaid can also cover nonemergency transportation to a doctor’s office or clinic. In fact, it’s estimated that this service was used for 59 million outpatient trips in 2015.
There may be some requirements for coverage of nonemergency transportation. For example, Medicaid may cover your transport if you:
- don’t have a car
- don’t have a driver’s license
- have a physical or mental disability
- can’t travel or wait for a ride by yourself
The type of transport provided may vary; it can include a car, van, taxi, or bus. You may also need to share your ride with one or multiple other people.
Each state runs its own Medicaid program. To see if you’re eligible for Medicaid and find out what transportation benefits are available, contact your state’s Medicaid office.
Programs of All-Inclusive Care for the Elderly (PACE)
PACE is a program that’s run jointly by Medicare and Medicaid. Under PACE, a team of professionals works to provide you with coordinated care. To be eligible for PACE, you must:
- have Medicare, Medicaid, or both
- be 55 years old or over
- live in an area that’s covered by PACE
- need a level of care that’s typically provided in a nursing home
- be able to live safely in your community with assistance from PACE
PACE covers all medically necessary services that Medicare and Medicaid cover. It may also pay for some additional services that these programs don’t cover.
The program will cover your transportation to a PACE center for medically necessary care. It may also cover transportation to a doctor’s appointment within your community.
You may be charged a monthly premium for some services. But you won’t have any copays or deductibles for PACE services approved by your care team.
Find out if there’s a PACE program in your area by using Medicare’s search tool or by contacting your local Medicaid office.
State and local programs
Your state or city may have additional programs that can help you find transportation. The programs and the types of services they provide may differ from one area to another.
One option is to look for Area Agencies on Aging (AAA) near you. AAA helps address the needs of people who are ages 60 and over, with a large focus on access to transportation.
To find state or local programs, including AAA, use the Eldercare Locator. This is a tool developed by the U.S. Administration on Aging that can help you find many different services in your area.
There are also commercial options available for your transportation needs. Some examples include:
- Uber Health. Family members and care providers can use this service, offered by Uber, to book rides to your medical appointments.
- GoGoGrandparent. GoGoGrandparent is offered in the United States and Canada. It helps people ages 50 and older request an Uber or Lyft or order meals or groceries for delivery. You need to pay a monthly membership fee for this service.
- SilverRide. SilverRide provides safe, assisted transportation in the San Francisco or Kansas City area. You pay per ride, and contactless payment is available.
Medicare covers some types of transportation for beneficiaries who need medical services. This can include both emergency and nonemergency transportation.
Both original Medicare and Medicare Advantage cover emergency transportation in an ambulance. Most of the time, original Medicare doesn’t cover nonemergency situations, unless approved ahead of time. Some Medicare Advantage plans may cover this service as an added feature.
There are additional resources you can use to get access to transportation services, including Medicaid, PACE, and state or local programs.
The specific services provided and eligibility requirements for these resources can vary based on your location. You can get more information by contacting your state’s Medicaid office or through the Eldercare Locator search tool.