Does Medicare Cover Transportation Services?

Medicare ride service is not something one might consider when choosing a healthcare plan. However, specific Medicare plans may offer coverage of expenses on transportation services. Seniors often have issues with transportation. The reasons may be different. In some cases, seniors can't afford to maintain their vehicles any longer or don't need a car as often as before. In other cases, seniors have difficulties moving around. Moreover, public transport is not always suitable. Walking to a destination point can become a real obstacle if the temperature is too low or too hot. Plus, the street may be overcrowded with pedestrians. Luckily, specific Medicare transportation services can be financially helpful to seniors. Keep reading the article to learn if you can expect reimbursement for your transportation expenses.

Emergency Transportation

So, is there some Medicare taxi service that helps seniors drive to specific destinations? Yes, and there are a few cases when seniors can expect coverage of their expenses. 

The Original Medicare (Part B of medical insurance) offers coverage of ambulance transportation for patients with Medicare. In simple words, the plan covers expenses for emergency transportation. This type of transportation can include:

  • emergency ground ambulance transportation to a hospital;

  • transportation to a critical access hospital;

  • transportation to a nursing facility to get medically necessary services.

The plan also covers expenses if transportation in another vehicle can risk a patient's health or life. 

What is an Emergency According to Medicare?

The Medicare Plan can cover transportation expenses if it's an emergency. But what does the organization mean by an emergency? Here are a few situations considered an emergency:

  • A severe risk to an individual's health.

  • A sudden medical crisis.

  • Inability to transport an individual from one location to another without the aid of medical or emergency services.

  • A severe loss of blood.

  • The person is unconscious or is in a state of shock.

  • An individual needs to receive Medicare-covered services.

  • Medical necessity.

In these cases, the Medicare Plan should cover seniors' expenses. But what about a Medicare transportation service that isn't an emergency. 

Non-Emergency Transportation

Specific healthcare plans may even cover a non-emergency Medicare driving service. For instance, Medicare Part B could cover limited non-emergency ambulance transportation services if a doctor writes an order describing a medical need. Typically, a doctor would write such an order for a patient with End-Stage Renal Disease (ESRD) or any other severely ill person. 

Medicare could also cover the following non-emergency transportation assistance for Medicare patients who are:

  • Unable to walk.

  • Unable to stand without assistance.

  • Unable to sit in a wheelchair or standard chair.

  • In need of critical medical services during a trip (i.e., monitoring of vital functions).

Note: if an ambulance company or provider has services for non-emergency cases but doesn't think Medicare would cover the expenses, they notify the patient beforehand by sending an Advance Beneficiary Notice of Noncoverage (ABN). It's a notice that notifies patients about the need to cover transportation services independently.

Medicare Transportation Example

The Medicare advantage transportation benefit is that the patient doesn't have to pay for their transportation expenses, or they cover a smaller portion out of their pockets. Check out the following united healthcare transportation example to better understand how it works.

Suppose Mark is a senior and he is subscribed to Original Medicare. His total out-of-pocket expenses include:

  • His monthly Medicare Part B premium.

  • Calendar year deductibles.

  • 20% coinsurance for specific pre-approved services.

Medicare utilizes a specific Medicare-approved amount to calculate Mark's claim payments. This approved amount is what Medicare will pay a doctor or medical supplier who works under Medicare and accepts assignment. 

The assignment is when a medical provider or a doctor agrees to accept the Medicare-approved amount as if Mark (or any other patient) paid in full. Typically, most providers take such assignments, and so does Mark's doctor. However, patients should verify this before using the services of a new facility or doctor.

Mark had an emergency and had to use Medicare transportation services. Here's what he had to pay for his ambulance bill in the table below. 

Type of expense

Cost

Total ambulance bill.

$1,500

Approved amount by Medicare.

$1,000: Medicare pays 80% which is $800

Out-of-pocker expenses.

The remaining 20% which is $200. 

According to this table, Mark doesn't have to pay the total amount for his transportation costs. So, does Medicare cover transportation? Yes, it covers 80%. 

Some plans may even offer special benefits. For instance, the Medicare Advantage plan can cover seniors' expenses to get to the doctor. Other plans even cover trips to a person's fitness facility or any other facility that benefits one's health. 

You can even sign up for plans that cover trips via Lyft or Uber. When choosing a plan, read carefully about what transportation coverage it offers. In the previous example, Medicare covers 80% of the pre-approved amount. Other plans have different coverage ratios. 

On this page

We recommend to read

View all arrow icon