Does Medicare Cover Transportation To Medical Appointments

Medical Transportation Services Covered Under Medicare Advantage

Depending on your type of Medicare Advantage plan, you could face the same costs for non-emergency ambulance transportation with Original Medicare. Or, you may have access to other, less expensive options. Medicare.gov has more information should you require it.

Does Medicare cover Uber or Lyft rideshare services?

Some Medicare Advantage plans are available now that will let you take advantage of Lyft or Uber. You can use these rideshare services for doctors appointments or outpatient facilities where they administer physical therapy, for example.

For obvious legal reasons, its not a good idea to call a ride-sharing service if you think you are having a medical emergency. But suppose youre seeking non-emergency care at an outpatient facility for medical appointments. In that case, this could be a cheaper and much more convenient option than what you might be able to get with Original Medicare.

What To Know About Medicare And Transportation Services

• Non-Medicare Transportation Options

• In most cases, Medicare only covers emergency transportation. However, there are situations where there will be Medicare transportation coverage for non-emergency, medically necessary services, such as in treatments for ESRD. A doctors note will be necessary.

• Some Medicare Advantage plans may have transportation as an added benefit, but this will vary greatly per plan. Medicare beneficiaries should always confirm with their insurance plan.

• Medicaid provides a non-emergency transportation service for eligible members known as Non-Emergency Medical Transportation . How the service functions will depend on the beneficiarys location.

• Medigap helps cover costs associated with ambulance services, but not ambulance services themselves.

• There are other options for transit to medical appointments, including Uber Health, Lyft Pass for Healthcare, and Oak Street Healths green van service.

As Americans grow older, their access to transportation may become diminished. Understandably, this can be an upsetting experience and a cause for concern. After all, transportation affects every part of modern life, including being able to see family and friends, purchase groceries, and run other important errands.

When Does Medicare Cover Nonemergency Transportation

Original Medicare doesnt 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, youll need a letter from your doctor stating that this transportation is a medical necessity and if approved, youre 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 wont cover, youll 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 youll be covered. You can also request prior authorization for nonemergency ambulance transportation from Medicare directly.

» MORE:Does Medicare cover ambulance services?

Also Check: What Is Medicare Part D Plan

Medicare Medical Transportation Services

Lindsay MalzoneReviewed by: Rodolfo MarreroHomeFAQsCoverage

Its almost inevitable that you will require medical transportation as you age. But did you know some of that is easily covered by Medicare? Its true! But its not the default, and you may not be eligible under certain circumstances.

Below, well go into more detail about which medical transportation services are and are not covered by your Medicare health insurance benefits.

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 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 , 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.

Don’t Miss: When Is The Special Enrollment Period For Medicare

Will Medicare Pay For Transportation From One State To Another

In emergency situations, the rules will follow the Original Medicare rules. You may live on a state line, and the nearest hospital will be over a state border. The one area where you need to be careful is with Medicare Advantage.

Transportation may be covered, but the hospital where you receive care could be out-of-network. Being out-of-network with Medicare Advantage may impact the reimbursement amounts. Check with your policy and understand all the networks within your geographical area to determine where you may have coverage gaps.

Medicaid May Cover Your Ride To A Doctor Appointment If:

• You donât have a working vehicle or a driverâs license.
• Itâs not safe for you to drive or wait for a ride to a doctor appointment because of a health condition, physical disability, or mental disability.
• You have no other reasonable means of getting to the doctor.

If your ride to a doctor appointment qualifies, Medicaid-covered transportation could include:

Itâs up to each Medicaid program to decide the most appropriate means of transportation for your ride to a doctor appointment. Keep in mind that Medicaid programs are state-run, and each state has its own criteria for medical transportation coverage.

If you use an ambulance company based in New Jersey, Pennsylvania, or South Carolina, you may be affected by prior authorization rules if you need non-emergency, scheduled, medically necessary ambulance services 1) three or more times over a 10-day period or 2) at least once a week for three or more weeks. To find out if these rules affect you, contact Medicare at 1-800-633-4227 , 24 hours a day, seven days a week.

Also Check: Is A Disabled Child Eligible For Medicare Benefits

Lyft Partners With Some Medicare Advantage Plans

The popular ridesharing company Lyft recently announced plans to expand its collaboration with certain private insurance companies to provide non-emergency transportation to doctors offices, pharmacies, clinics and other health care facilities.

The company began partnering with private insurers to provide transportation to medical appointments for plan members who live in areas that lack public transportation.

Lyft later enhanced its efforts to include rides to pharmacies, and the most recent change will expand those services to hundreds of additional cities.

In a 2019 report released by Lyft, more than a quarter of Lyft riders said that the service helped them get to a medical appointment that they would have otherwise missed.1

And thats not the only evidence to support the success of the partnership. One Medicare Advantage provider reported a 39 percent drop in ride costs and a 40 percent decrease in wait time for its patients after partnering with Lyft.2

Lyft is not only helping patients get to their appointments. The company is also helping qualified beneficiaries arrange other transportation.

Rides with Lyft are booked using a smartphone. But because many Americans over the age of 65 do not use smartphones, Lyft has been implementing upgrades to its Concierge feature, which allows businesses to book rides for customers on their behalf.

How Do Original Medicare And A Medigap Plan Cover Transportation

Original Medicare and your Medigap plan work together to cover your Medicare-approved transportation costs.

Medigap plans are designed to supplement Original Medicare, meaning they “fill the gap” or address costs left over after Medicare pays. If Medicare rejects a transportation claim and your Medigap plan does not cover the service, then you would be responsible to pay the full amount for the ambulance.

When you receive services, present both your red, white and blue Medicare card and your Medigap identification card to your provider. Your provider then submits the charges to Medicare. If Medicare approves the service, theyll cover their portion, then use an automated “crossover” system to notify your Medigap insurance company of the remaining charges . You or your health care provider generally do not need to file a separate claim with your Medigap plan.

Don’t Miss: What Medicare Plans Cover Dental Implants

How Much Does Medicare Part B Cost

When you enroll in this part of Medicare, you are responsible for its costs such as premium. In 2022, the standard Medicare Part B premium is $170.10 each month.

However, those in a higher income bracket will pay a higher monthly premium.This higher monthly premium is due to the Income Related Monthly Adjustment Amount . IRMAA is calculated by looking at your annual income and using a sliding scale to determine your premium.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

For most beneficiaries, the premium is automatically deducted from their monthly Social Security benefits check. If you do not receive Social Security benefits, you will get a quarterly bill from Medicare.

Medicare offers an online payment option called Easy Pay, which you can access with a MyMedicare account. Additionally, you may pay your quarterly premium by mail instead.

Alongside the premium, your Medicare Part B coverage includes an annual deductible and 20% coinsurance, for which you are responsible for paying out-of-pocket. In 2022, the Medicare Part B deductible is $233.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

If you are a lower-income beneficiary and are dual-eligible for both Medicare and Medicaid, you may qualify for a Medicare Savings Program.

Dont Miss: When Can You Join Medicare

Does Original Medicare Cover Transportation For Medical Reasons

Original Medicare generally does not cover transportation to get routine health care. However, it may cover non-emergency ambulance transportation to and from a health-care provider. You need to have a health condition diagnosed or treated and other forms of transportation could endanger your health. Your doctor must provide a written order verifying that ambulance transportation is medically necessary because of your health condition.

Read Also: Can You Qualify For Medicaid If You Have Medicare

Medicare Coverage For Emergency Ambulance Transportation

Medicare Part B covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital or skilled nursing facility for medically necessary services and transportation in any other vehicle could endanger your health.

In some cases, Medicare may pay for limited, medically necessary, nonemergency ambulance transportation if you have a written order from your doctor stating that ambulance transportation is medically necessary. For example, you may need a medically necessary ambulance transport to a dialysis facility if you have end-stage renal disease .

If you want to skip the facility thats closest to you in favor of a facility that’s farther away, know that Medicare will cover only the cost of taking you to the closest appropriate facility. But if no facility in your area can give you the care you need, Medicare will pay for you to be taken to the nearest facility that can.

If you have a sudden, serious medical emergency , Medicare might cover an ambulance ride if you can’t be safely transported by a car or taxi.

If your condition is so serious that ground transportation isn’t fast enough, Medicare might cover the cost of an air ambulance, either a plane or a helicopter.

In addition, your situation must meet at least 1 of the following conditions:

• You can’t easily be reached by ground transportation
• Long distances or heavy traffic could prevent you from getting care soon enough if you traveled by ground

What Type Of Transportation Does Medicare Cover

Whether its an ambulance ride to the hospital or a lift to the doctors office, transportation plays a big role in our health. And as you enroll in Medicare, you may be wondering what type of transportation is covered under your plan.

Lets dive into the details about Medicare and the different types of medical transportation it may cover

Read Also: Does Aarp Medicare Complete Cover Cataract Surgery

How A Medicare Demonstration May Impact Non

Demonstration projects allow the Centers for Medicare & Medicaid Services to test and measure the likely effects of potential program changes, including new types of services and delivery methods, as well as new payment approaches.

Under one of these demonstrations, CMS is testing a Medicare prior authorization model for ambulance transport in eight states and the District of Columbia. If you live in one of these states and use non-emergency ambulance services regularly, you may need to take extra steps to submit your Medicare medical transportation charges for review:

This Medicare demonstration applies if you receive scheduled, non-emergency ambulance transportation at either of these frequency levels:

• Three or more round trips in a 10-day period.
• At least one trip per week for three weeks or more.

Under the demonstration, you or the ambulance company may send a request for prior authorization to Medicare before your fourth round trip in a 30-day period. This will let you and the company know earlier in the process if Medicare might cover your services.

If your prior authorization request is denied and you get the services anyway, Medicare will reject the claim and the ambulance company may bill you for all charges.

What Medical Transportation Options Exist For Seniors On Medicare

Seniors on Medicare that face mobility issues and live on a limited or fixed income have a number of options at their disposal for being transported to and from important appointments, including doctor visits.

You may wonder, however, whether Medicare actually covers the cost of these transportation options and what alternatives are at seniors disposal in the event a particular service is not paid for under their insurance plan.

Its worth noting that non-emergency transportation is usually not covered by standard Medicare plans, although a number of Medicare Part C plans will.

Emergency transportation in a life-support ambulance is covered across the board on Medicare but this is generally considered to cover life or limb issues or a matter where going to the hospital in a vehicle like a family members car would increase any medical risks the senior is facing. Deductibles may also apply in emergency situations, depending on the seniors exact Medicare plan.

Medicaidcan cover a patients transport expenses in a wider array of circumstances, such as:

• If the person has a low income.
• If they cant drive a car, dont have a drivers license, or face some other impediment to private, self-arranged transportation.
• If they are impacted by a disability.

Our general advice is to urge seniors and their families to double check the benefits provided by their Medicare plans before making a decision about transportation.

What about Uber?

How Rides to Wellness Can Help

Recommended Reading: How Will Bernie Sanders Pay For Medicare For All

What Medicare Will Not Cover

Medicare will not pay for a number of services sometimes provided as part of home health care, including:

• drugs and biologicals administered at home
• personal care by part-time home health aides if this is the only care you need
• meals delivered to your home
• housekeeping services, or
• full-time nursing care.

If you require durable medical equipment, such as a special bed or wheelchair, as part of your home care, Medicare will pay only 80% of the costs.

For more information on Medicare coverage of home health care, read Medicares online publication Medicare and Home Health Care at .

Recommended Reading: What Is A Good Secondary Insurance To Medicare

Does Medicaid Cover Non

Medicaid does cover the cost of emergency medical transportation for those eligible and their medical needs are immediate. This includes being seriously injured, or the case of a heart attack for example. In these cases, an ambulance or medical flight may be required and pre-approval for emergency transportation is not required. Non-emergency transportation, such as needing a ride to a medical appointment, is not considered an emergency but rides may still be available. Medicaid can cover rides to and from a doctorâs office, the hospital, or another medical office for Medicaid-approved care.

Recommended Reading: How To Be Eligible For Medicare And Medicaid

Unitedhealthcare Connected Benefit Disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

You can get this document for free in other formats, such as large print, braille, or audio. Call , TTY 711, 8 a.m. â 8 p.m., local time, Monday â Friday . The call is free.

You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

Language Line is available for all in-network providers.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al , TTY 711, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del dÃa,/los 7 dÃas de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustarÃa recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.