Does Medicare Cover Medical Transportation?
Key takeaways:
Original Medicare and Medicare Advantage plans cover emergency medical transportation.
In certain cases, original Medicare will cover nonemergency medical transportation that is medically necessary, such as transportation to dialysis for someone with permanent kidney failure. Medicare Advantage benefits always meet or exceed what’s covered by original Medicare.
You may have broader transportation benefits, such as rides to doctor appointments, if you have certain Medicare Advantage plans — particularly Special Needs Plans — or if you are dually eligible for Medicare and full Medicaid.
Table of contents
Getting back and forth from the hospital or medical appointments might not be the first thing that comes to mind when you think of healthcare expenses. But these costs can add up.
If you have original Medicare or a Medicare Advantage plan, you are covered for emergency medical transportation, including ground ambulance and air ambulance, if needed.
Original Medicare will also cover some nonemergency transportation if it’s deemed medically necessary. Medicare Advantage (MA) plans meet or exceed original Medicare’s benefits. In fact, many MA plans will cover routine medical transportation for doctor appointments as a perk of choosing these private alternatives to original Medicare.
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What is medical transportation?
Medical transportation brings people to places where they receive healthcare services.
Transportation can be for emergency or nonemergency reasons. Emergency medical transportation includes ground ambulance and air ambulance.
Nonemergency medical transportation (NEMT) includes rides to doctor’s appointments and dialysis for people who don’t have vehicles, fares for public transportation, or someone who can bring them for care.
NEMT is important for people to have continuity of care. Lack of transportation is a social determinant of health that can affect health outcomes. In fact, the Robert Wood Johnson Foundation and the Urban Institute found that transportation barriers — such as not having access to a vehicle or public transportation or difficulty finding a ride — caused 1 in 5 adults to skip necessary healthcare services in 2022.
Medical transportation for someone using a wheelchair or scooter may require a specially equipped vehicle.
What medical transportation services does original Medicare cover?
Original Medicare covers ambulances and certain medical transportation for routine care.
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Medicare Part B covers ground ambulances if you need care from a:
Hospital
Critical access hospital
Rural emergency hospital
Skilled nursing facility
Part B also covers emergency air ambulance transportation on a helicopter or plane if you need rapid transport that a ground ambulance cannot provide because of the distance or heavy traffic.
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In certain cases, original Medicare will pay for nonemergency ambulance transportation if your healthcare professional deems it medically necessary via a written order. For instance, a person with end-stage renal disease (ESRD) may need medical transportation to a dialysis center. You also may have broader transportation options if you are covered by Medicare and full Medicaid.
Do Medicare Advantage plans offer transportation benefits?
Yes. According to KFF, 36% of MA plans offer transportation benefits for medical needs in 2024.
MA plans meet or exceed original Medicare’s coverage of emergency and nonemergency medical transportation. In fact, many MA plans tout coverage of routine medical transportation for doctor’s visits as an extra benefit beyond what’s covered by original Medicare.
For instance, you may be able to get coverage for a ride to a fitness center. Some MA plans may also cover medical trips via ride-hailing services like Uber and Lyft. Extreme heat led at least one MA plan to cover transportation to cooling centers in the summer of 2022 to help enrollees avoid heat-related illnesses.
If you are covered by one of MA’s Special Needs Plans — which are special types of plans that provide benefits and coordinated care to people with certain conditions — you typically have access to even broader transportation options. However, you may need prior authorization from your MA plan for nonemergency medical transportation coverage.
How do you get medical transportation covered by Medicare?
Speak with your healthcare professional about your condition to see whether transportation can be deemed medically necessary and can be requested as part of your medical care through a written order.
If you have an MA plan, you may have coverage for medical transportation for emergency and routine care. Contact your plan for more information about your benefits.
Out-of-pocket costs for Medicare transportation
After you meet the Part B deductible, Original Medicare will pay 80% of covered medical transportation costs. You are responsible for 20% of the Medicare-approved expenses.
Medicare Part B typically covers emergency transportation to the closest facility that can provide the care you need. If you go elsewhere, the ride won’t be covered and you could be responsible for the entire bill.
You also may face prior authorization for nonemergency medical transportation after you take 3 or more scheduled round trips in a 10-day period or at least 1 a week for 3 weeks.
And if an ambulance company believes Medicare won’t pay for a nonemergency ride, they may give you an advance beneficiary notice of noncoverage.
If you have MA, your out-of-pocket costs will vary based on your plan.
What can you do if Medicare doesn’t cover your transportation costs?
If your Medicare plan doesn’t cover medical transportation, there are other ways to access free or low-cost services. They include:
Ambulance membership programs: Some hospitals, fire departments, and ambulance services offer ambulance membership programs. There is typically an annual fee for an individual or household in a service area. If you’re not in the service area when you need help, you may not be able to get a ride that’s covered by your plan.
Eldercare Locator: This nationwide online tool helps seniors connect with an Area Agency on Aging to find free and low-cost transportation.
Medicaid: Under the nonemergency medical transportation benefit, people with Medicaid qualify for assistance getting to and from doctor’s appointments. That’s because transportation to medical care is a mandatory Medicaid benefit. As a result, some state Medicaid programs cover the costs of taxis, Uber, and Lyft.
National Aging and Disability Transportation Center: This organization advocates for available and accessible transportation for seniors, people with disabilities, and caregivers. They can help you find free and low-cost transportation in your area.
Paratransit: If you have a transit system in your area, your condition may make you eligible for paratransit services for free or at a low cost. Paratransit provides door-to-door service via vans, minibuses, or other vehicles. This type of transportation usually requires a reservation. Contact your local transit authority for more information.
Rides in Sight: This national referral service helps seniors and visually impaired people find transportation options.
Can I appeal a denied claim?
Yes, you can appeal a denied Medicare claim for medical transportation. The appeals process depends on whether you have original Medicare or MA.
Types of aftercare or equipment associated with medical transportation that Medicare covers
Medicare Part B covers medically necessary durable medical equipment (DME). Some covered DME that can be associated with medical transportation includes:
Canes
Crutches
Oxygen equipment and supplies
Scooters
Walkers
Wheelchairs
You can request wheelchair accessible medical transport if you have a wheelchair or scooter and require mobilized seating.
Can Medicare supplement insurance (Medigap) help cover medical transportation?
Medigap is a supplement insurance plan for people covered by original Medicare.
It is an extra insurance plan that you buy from a private company. It helps to cover some or all of your out-of-pocket Medicare expenses like deductibles, copays, and coinsurance.
None of Medigap’s plans have specific benefits for medical transportation.
The bottom line
Medicare and Medicare Advantage plans cover medical transportation in certain emergency and nonemergency situations. Ground ambulances are covered for emergencies, and air ambulances also may be covered depending on the urgency and other circumstances. Original Medicare may cover your rides to healthcare appointments if they are deemed medically necessary, such as transportation to dialysis.
More than one-third of Medicare Advantage plans offer broader transportation benefits than original Medicare. If your medical transportation isn’t covered by your Medicare plan, you may be able to access free and low-cost rides through your local transit system’s paratransit services or find senior transportation options.
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References
Centers for Medicare & Medicaid Services. (2016). Fact sheet: Let Medicaid give you a ride.
Centers for Medicare & Medicaid Services. (2023). Medicare coverage of ambulance services.
Centers for Medicare & Medicaid Services. (2023). Non-emergency medical transportation (NEMT).
Cigna Healthcare. (2022). As temperatures rise, Cigna offers Medicare Advantage customers rides to cooling centers at no extra cost.
Dignity Health. (n.d.). Ambulance membership program.
Eldercare Locator. (n.d.). Transportation.
Freed, M., et al. (2023). Medicare Advantage 2024 spotlight: First look. KFF.
Medicare.gov. (n.d.). Ambulance services.
Medicare.gov. (n.d.). Durable medical equipment (DME) coverage.
Medicare.gov. (n.d.). End-stage renal disease (ESRD).
Medicare.gov. (n.d.). How do I file an appeal?
Medicaid.gov. (n.d.). Mandatory & optional Medicaid benefits.
Medicare Interactive. (n.d.). Advance beneficiary notice (ABN).
National Aging and Disability Transportation Center. (n.d.). ADA & paratransit.
National Aging and Disability Transportation Center. (n.d.). Aging and disability transportation overview.
Ochieng, N., et al. (2023). Medicare Advantage in 2023: Premiums, out-of-pocket limits, cost sharing, supplemental benefits, prior authorization, and star ratings. KFF.
Smith, L. B., et al. (2023). More than one in five adults with limited public transit access forgo health care because of transportation barriers. Robert Wood Johnson Foundation.
