Rides to routine medical appointments generally aren’t covered on Original Medicare — and they’re covered on only some Medicare Advantage plans. However, both Original Medicare and Medicare Advantage cover emergency and certain nonemergency ambulance transportation.
When does Medicare cover nonemergency transportation?
Original Medicare doesn’t cover rides to routine medical appointments, like annual physicals, follow-ups or urgent care visits. In certain circumstances, however, Medicare Part B may cover medically necessary, but nonemergency, ambulance transportation, such as a ride to dialysis for someone with end-stage kidney disease.
Before you can be approved for ambulance rides, you’ll need a letter from your doctor stating that this transportation is a medical necessity — and if approved, you’re covered only for rides to and from the nearest Medicare-eligible medical facility that handles your specific condition.
If you arrange nonemergency ambulance services that the ambulance company suspects Medicare won’t cover, you’ll receive an Advance Beneficiary Notice of Noncoverage as a warning that you may be responsible for the bill. Additionally, if you live in certain states and book three or more nonemergency round trips in a 10-day stretch or at least one round trip per week for three weeks or longer, the ambulance company may ask you for prior Medicare authorization before a fourth trip to make sure you’ll be covered. You can also request prior authorization for nonemergency ambulance transportation from Medicare directly.
How much does nonemergency transportation cost with Original Medicare?
If approved for nonemergency transportation through Original Medicare, you’re responsible for meeting the Medicare Part B deductible of $233 in 2022, along with 20% of your Medicare-approved costs.
Does Medicare Advantage cover nonemergency transportation?
Medicare Advantage plans are required to provide the same coverage as Original Medicare, so all Medicare Advantage plans will at the very least cover the same types of nonemergency ambulance transportation as Original Medicare. Since Medicare Advantage plans are offered by private insurance companies, any coverage that goes beyond Original Medicare (as well as required copays, coinsurance and deductibles) will vary from insurer to insurer, and from plan to plan.
Some Medicare Advantage plans do cover health-related transportation — not only to routine medical appointments, but also to pharmacies to pick up prescriptions — and sometimes even to gyms. Depending on your Medicare Advantage policy, you may be able to hire ride-sharing services (like Lyft or Uber), taxis or vans to get to and from your appointments with a low or $0 copay, resulting in little or no out-of-pocket cost.
What do private transportation services cost?
The cost of hiring a ride to get to a medical appointment varies widely based on factors including miles, tolls, the type of vehicle and whether you need special accommodations like a wheelchair or a stretcher. Each company has its own method of calculating rates, but to get a rough idea: A full-priced trip of about 10 miles to a local hospital in the Northeast could cost around $14-$21 each way with Lyft or Uber, while travel with a private medical transportation company with required accommodations could run $200 or more for a round trip, including wait time. If you need to hire private transportation, it pays to shop around in advance to find the most reasonable available option.
Are there affordable transportation alternatives?
If you need nonemergency medical transportation that your Medicare plan doesn’t cover and you aren’t able to afford commercial rides, a number of organizations nationwide provide free or low-cost transportation.
Dial-a-ride services: Many communities offer on-demand dial-a-ride services, which often accommodate physical disabilities and are either inexpensive or free to use. Be aware that you may have to provide up to 48-hour notice to schedule your rides, although some areas offer same-day service based on availability. Eligibility to use dial-a-ride varies from location to location, so check with your local provider to make sure you’re eligible before scheduling a trip.
National Volunteer Transportation Center: Operating in all 50 states and Puerto Rico, NVTC connects seniors with volunteer drivers and shared-ride programs that provide free rides. Depending on the providers in your area, these rides may be door-to-door — but in some cases, your driver may also be able to accompany you inside to your appointment or remain with you to provide assistance.
Administration for Community Living: Connects you with local agencies that provide transportation services for seniors through its online Eldercare Locator tool or by speaking with a live representative on the phone by calling 800-677-1116.
National Aging and Disability Transportation Center: This assistance center can help you find affordable transportation by setting up a personal phone consultation as well as possible technical assistance and conference calls to connect you with people who have navigated similar situations. You can call 866-983-3222 on Monday to Friday from 9 a.m. to 5 p.m. Eastern time.
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).