Medicare Coverage of Nonemergency Transportation

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 in nonemergency situations. However, Medicare Part B sometimes covers nonemergency ambulance transportation between home and a hospital or other place of treatment or diagnosis if the patient's doctor certifies in writing that transportation in something other than an ambulance would endanger the patient's health (see Ambulance Services).

A written statement by a doctor is necessary for Medicare Part B coverage of nonemergency ambulance coverage, but it doesn't guarantee Medicare coverage. To be certain of coverage for nonemergency ambulance transportation, ask the treating physician's office to get prior approval from Medicare Part B. If a patient hires ambulance transportation but it isn't approved by Medicare Part B, the patient could be personally responsible for the full cost.

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, 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 nonemergency ambulance services if it approves those services based on a written statement of medical necessity from the patient's doctor.

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.

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33 Comments So Far. Add Your Wisdom.

Anonymous said about 1 month ago

Medicaid which is free covers transportation but Medicare and MOST Advantage do not offer transportation something in which we pay for . This is laughable, SSDI threatens to remove benefits if your disabled and not adequately meeting they consider an effort to change your health or situation but A LOT of people can't drive or do not have public transportation. Yes there are CAP locally but they are not reliable, are not trained, properly insured or even reasonably screen to be an effective resource . Don't get me wrong CAP does it's best to help but one can't miss appt. after appt. because drivers flake out or there's no drivers available . I've now lost one of the best surgeons around because of transportation issues !

about 1 month ago

everything part J medicare covers, theriputic heated pools , huvaround, ect.

3 months ago

This is a tremendous frustration! I fail to understand why with such push to "fix" the health care system we continue to let our elderly and disabled suffer the burden of the broken system as last priority. I find it completely unreasonable that those with Medicaid qualify for a no cost ride to non-emergency medical services (which I think they ought to), but those with Medicare do not have the same benefit. I find it particularly abominable for those whom, if not disabled, would financially qualify for the service under Medicaid, or one of its subsequent programs. For example, my father qualifies for medical transportation through VHAP (Vermont Health Access Program, which now has a different name) financially. However, because he is permanently disabled he was forced to switch insurance, to choose between Medicare and private insurance, neither of which he was able to afford (but that is for another rant). The obvious choice was Medicare, because it was less expensive than any alternative, Medicaid and its subsequent programs notwithstanding. You see, in Vermont, once you are disabled, you only have a certain length of time on "state" health insurance before you are automatically switched to "federal" health insurance, barring those of the lowest income who can receive both Medicare and Medicaid jointly. Now on Medicare, my father no longer receives the medical transportation to non-emergency services on which we once relied. The real kicker here, for anyone that is still reading and paying attention, is that if my father had WORKED LESS or EARNED LESS during his capable working years, he would still qualify for the services of transportation. You see, it is the his disability benefit amount that forces him out of the very lowest income bracket so he cannot have the dual benefit of Medicare and Medicaid; he only ever qualified for VHAP, not full Medicaid. 
 Okay, Rant over, my long winded response was meant to point out that those with Medicare do not qualify for medical transportation, even if some of them would financially qualify were they not evaluated differently because they are disabled or elderly. 

Anonymous said 5 months ago

Seems to me that anyone who is disabled or elderly ALWAYS has to pay for medical needs the government and/or citizens don't feel we need. They dont even look at the big picture whuch is disheartening and we have to struggle with things like not having transportation to medical appointments. You have this program with no way for us (the disabled) to get to proper health care. What kind of mindless, heartless cruelty is this?! I have Multiple Sclerosis and my vision is so bad, I'm not allowed to drive! Im in a new state and have not seen a general practioner or neurologust in a year, have several lumps in both breasts, asthma, running out of meds that I usually get through the mail from pharmaceutial companise that ended moths ago when my son and I escaped my abusive husband and left with only what we coukd carry which means we're split up and im barely homeless as I speak because I couldnt get any help from the last state I wss in. Seems to me, though I worked since the afe of 15 and disabled at 31 through heredity, not drug or alcohol use, I would have been better off having 6 kids by 6 different men and collecting welfare since the government seems to think that a person with no family connections or anyone else reliable on $670 a month can afford to call a cab everytime we need to leave the house. This is more than rediculous, its cruelty via the government and I honestly do believe they are getting rid of people ghrough process of elimination.

5 months ago

I have been disabled for 15 yrs. I have Medicare part A and B. My husband worked from home so he has been able to take me to my pain clinic. He is going to start working back in a office over an hour away. I need tranortation to see my Doctor and to pick up medication prescriptions. I also have procedures done and need a driver. I do not have a car ans must have a driver when I go to get percriptions and procedures. What am I suppose to do? Lay at home in bed and become worse. The pain clinic has been a miricle. I need help!

Anonymous said 7 months ago

It is really quite simple, Medicare does cover very limited non emergent ambulance transport if the person say for example cannot weight bear, or is a hoyer life, and there is documentation to support the need for the use of an ambulance. The problem seems to be and I see it every day, how lax the health care community is when they set up transportation and just assume because a person cannot walk they need an ambulance for non emergent transportation. If everyone knew and understood the regulations, and followed them then there would be less wasteful spending in health care. Ambulance companies are out to make a profit, and they need to follow the rules or else face a fine, they depend on the hospital and facilities to know the regulations and have the supporting documentation that indicates the medical necessity. Just because a MD write ambulance transport does not mean it will be covered.

7 months ago

Medicare does not provide easily accessible non medical transportation because Medicare was the result of a huge battle in the early 1970's between those who wanted health care for everyone regardless of income and those who believed that the US free market system could provide health services for everyone. The format and services in Medicare are a hybrid between the two forces. In Medicare, the difficulty of finding support for covering costs for non-medical transportation is a gap in services that is a stark demonstration of the reason for the 1970's battle - transportation in the free market ranges from moderate to very high cost. Those of us who can't afford the moderate level cost but who are not quite poor must pay for transportation ourselves or go to great lengths to find support for the cost. Part of the price we all must pay for services operated by businesses that must make a profit. Almost all health and health related services are expensive in the US in part because we as citizens don't approve of fully paying for an individual's essential human needs. This means that basic need services are monetized and private business provides the service at whatever rate the market will bear. To minimize the likelihood that a crucial need will only be met for those who can afford private services, our legislators set up government mandates to cover costs at an established rate for certain categories of people. Through our choice of elected representatives, we are the people who make the decision about rates and who those categories are. At this time, with a broken leg, I find myself among the category that can't afford the moderate rates and just discovered that neither my Medicare Supplement nor Medicare will pay for ordinary transportation to the orthopedic doctor's office. Public transportation was discontinued in my area of town about 9 years ago. Further, the private service available through the public bus system will not transport me unless I have insurance coverage. I'm not sick or permanently disabled so I don't need an expensive ambulance, a van with those automated steps will do.

Anonymous said 8 months ago

To maryannsynan2012-gma. MedicAid DOES appear to have some coverage for transportation to medical appointments, although that could vary by state. Where my parents live in Montgomery County, MD, there is a way to get free taxi service. Check in your area.

Anonymous said 8 months ago

The information about non emergency Medicare transportation is bot clear. All illness is important. Retires are living on fix income and do not have funds to go to the doctor

Anonymous said 9 months ago

A relative is in a rehab nursing facility and needs dialysis. The staff states that the family will need to provide transportation to dialysis because the relative is not bed-ridden; therefore medicare will not pay for transportation. Is there any non-emergency transportation service available for dialysis transport?

9 months ago

i have medicade and dont have a way to get to my doctores i have servere depression need to know if i qalifly

Anonymous said 10 months ago

Welfare strictly states that u don't qualify for pickup because of medicare and that's wrong, all they are is sharks stealing free money from Medicaid,and the services that transport are following suit,it's nothing short of open discrimination! Let's just be honest and say that no one under 50 should get hurt,we want retirement states to take elderly money for our own requirements put them in home's if u don't meet the requirements,move! Least then,you'd be telling the truth!

11 months ago

If you are In a hospital and need to be transported to a Rehab and your primary payor source is FFS Medicare, you would need to meet the Ambulance transportation Qualifer in order for Medicare to cover the cost of transport. Medicare only covers medically necessary use of ambulance. If your Medicare is an HMO they may cover the cost of transportation from the hospital to the snf.

12 months ago

is there free transportation any where back and force to drs for people on medicare

Anonymous said about 1 year ago

my brother had cancer, heart failure, diabetes etc but in texas( Brenham) not had transportation specialty he is disability and his try need help no body direction him to whoes, cancer center in brenham not had transportation for disability person who had colon cancer and is now his stack nothing help to and go tro Doctor for treatment, he try cal 211 not eligible too. do you trhink goverment send ot him just for die??????????????????i real need help..........

Anonymous said about 1 year ago

I'm having knee surgery next week. After three days I'm going to a medical center for theropy. I won't be able to drive at that time and I'm wondering if my transportion (about sixty miles will be covered by medacare)?

about 1 year ago

Hospice is no longer a place but, rather, a philosophy of care that offers spiritual,mental, emotional, physical, and medical support to those facing one of life’s greatest journeys. It is a compassionate approach that allows those faced with a life-threatening illness to maintain dignity and control over their lives and to spend quality time with their family and friends in the comfort of their own homes whether that is in a private residence, skilled nursing facility, or assisted living facility. The goal is not to cure, but to provide comfort and maintain the highest possible quality of life for as long as possible.

Anonymous said over 1 year ago

From what I have found so far on this subject, if you get Medicaid you can get help with transportation and there are services you can call, or you can have someone sign up for mileage reimbursements as an "Individual Transportation Provider" (or you can sign yourself up for some reimbursement) as an ITP. However, if you are on SSD and get Medicare, you can get NOTHING in the way of help for transportation to and from doctor visits, etc. I was trying to figure out how I'm going to get my son home from the hospital he was transferred to which is 2 hours from where we live. My financial situation is dire at the moment and I don't know how I will afford to travel so far when I don't have the funds for gas at the moment? Why is it that if you worked steadily and payed into the system, you seem to get dumped on but if you didn't,couldn't or wouldn't work enough to pay into the system then you get Medicaid immediately upon receiving SSI. My son had to wait for over a year after he started receiving SSD before he could get Medicare and they wouldn't give him Medicaid. I don't get it and it makes me feel like he got dumped on for working so hard for so many years before his disability came about. I know quite a few people who receive SSI and some of them never paid a dime into the system and others paid very little because they didn't work throughout their lives, or didn't work much, yet they got Medicaid medical coverage right away. I'm sorry to rant, but it just feels so unfair the way it's all done and decided. I have nothing against anyone personally, so I hope no one takes offense to my rant . I just needed to vent and add what I'm finding on the subject.

over 1 year ago

Hello, offers other informational resources that may be helpful. Perhaps an in-home care provider can assist as well. Your local Area Agency on the Aging may be able to help you locate an affordable service:

Anonymous said over 1 year ago

I recieve ss disability and get medicare and medicade, Im 55 years old and also had a above knee amputation. Im having a hard time getting non emergency transportation to my doctors appointments.They say I don't qualify.I only recieve 11.00 dollars more than people that gets ssi. What will i have to do ,just not go to my doctors appointments because of not having transportation?

over 1 year ago

I just looked into this and Medicaid will pay for transportation services to and from your doctor. So if you are low income you can go to your state office and apply for medicaid and get the transportation you need.

over 1 year ago

I have known of several people who were provided medical transportation to and from their doctors appointments. So I am not sure why you are stating that medicare/medicaid will not pay for this.

almost 2 years ago

My dentist has scheduled a surgery for which I will be unable to drive that day. I have a car but have nobody to drive me. I wonder if Medicare transport will help

almost 2 years ago

When you on a fixed income it's hard to get extra help when you need it. How they forget we worked hard for our money and now at our age we have to fight for what we earned .

almost 2 years ago

It seems to me the elderly need help now more than ever. They work hard for their money to get nothing now!!!

about 2 years ago

There's a lot of fantastic <a href="">medical transportation services in NJ</a>. Some people don't realize what is put into it, until it's too late.

almost 3 years ago

Very interested blog. I like this blog after read. You also should read this blog and i hope you also like it.

almost 3 years ago

A doctor has recommended that I get an endoscopy and a colonoscopy to help diagnose my digestive problem, but the tests require that you have a driver. I'm not disabled; I have a vehicle and can drive it, but I have no friends or family close by who drive, or who could drive me on weekdays. I have no debt, but I am on a low, fixed income. I'm wondering if I would qualify for Medicare-paid medical transportation if I get a written statement from a physician.

Anonymous said about 3 years ago

It only mentions ambulance I need to know about a van that comes to your home and takes you to the hospital and back home

Anonymous said about 3 years ago

Anonymous said about 3 years ago

I just wanted to know if a medicare patient could get a medical van to take them back and forth from her home to the hospital for lung treatment,

over 3 years ago

An interesting info. I wonder where and how did you base all these? these are all catchy and I had a great time reading your entire post. Thanks!

over 4 years ago

This information is misleading. According to Medicare publication 11021 "Emergency and Non-Emergency Transportation", pg 5 states "In some cases Medicare may cover ambulance services from your home or a medical facility to get care for a health condition that requires you to be transported only by ambulance." It further states "Non-emergency ambulance transportation may be provided, in some cases, when you need ambulance transportation to diagnose or treat your health condition and use of any other method of transportation could endanger your health." "In some cases, Medicare covers limited non-emergency ambulance transportation if you're confined to your bed, and you have a statement from your doctor or other health care provider saying that ambulance transportation is necessary because of your medical condition. Even if you aren't confined to your bed, in some cases, Medicare may still cover your non-emergency ambulance trip if you have this statement." So check your information and quit misleading the elderly.


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