What It Is

Nonemergency transportation of a patient to and from home

What's Covered

Neither Medicare Part A nor Medicare Part B covers routine transportation for a patient to or from home.

Medicare Part B covers transportation by ambulance only in emergencies, or for non-emergency transportation to or from a hospital or skilled nursing facility if the patient's doctor certifies that any non-ambulance transportation would endanger the patient's health (see Ambulance Services. In no case does Medicare pay for transportation between a patient's home and a doctor's office.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for routine transportation to or from home, contact the plan directly.

What Medicare Pays

Medicare pays nothing for most nonemergency transportation.

Medicare Part B pays 80 percent of the Medicare-approved amount for covered ambulance services.

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

• The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

• The care must be performed or delivered by a healthcare provider who participates in Medicare.