Does Medicare Part A cover wheelchair van transportation?

2 answers | Last updated: Nov 12, 2016
Ktunnell asked...

Does Medicare part A cover wheelchair van transportation to and from a nursing home for Dialysis treatment?

Expert Answers

Not Medicare Part A, which covers inpatient hospital or nursing facility care. But there's a small chance that Medicare Part B, which covers outpatient care, might cover wheelchair van transportation. Normally, Medicare Part B only covers ambulance transportation, and only in an emergency when any other form of transportation would endanger your health. It does not usually cover non-emergency transportation between home and a doctor's office or treatment facility. In a few cases, however, if a doctor prescribes special transportation in order to protect a patient's health, Medicare Part B might consider paying for it. Discuss the possibility with the doctor who is overseeing the dialysis, and see if the doctor is willing to prescribe such transportation. If so, you would then have to find a van company that participates in Medicare, and the van company would have to submit the doctor's prescription to Medicare Part B for approval. All in all, the odds are against it.

A more likely way to find help with the cost of wheelchair van transportation is through a local community medical transportation program. You can ask at the dialysis center and the nursing home if they know of any such program. Or, you can call the Eldercare Locator toll-free at 800-677-1116; they can direct you to a local medical transportation program in your area.

Community Answers

A fellow caregiver answered...

Medicare Part B will cover an ambulance transportation to/from dialysis, or to/from a hospital if you meet "medical necessity". This means you can not travel by a wheelchair van, are bed confined and are unable to sit up for the duration of the transport. Your physician will have to sign a medical necessity form, which the ambulance provider will have to submit with their bill.

Medicare will only pay for a doctor's visit if it is an "emergency" whereby the unit stopped for stabilization of the patient, and then proceeded to the ER. Medicare will not pay for a transport to a doctor's office, but will cover the transport from the doctor's office IF you are going to an emergency room or hospital.

Ambulance services are billed under Part B. If you are admitted to a hospital or a SNF and are returning to that room (not discharged under a Part A stay), then the ambulance provider will bill the hospital or nursing home for the service. There are exceptions, such as dialysis, catheterizations, emergencies, chemo, etc where the ambulance provider will bill your Medicare Part B directly.

Remember, you are still obligated to cover your 20% Part B Co-Pay.

Medicare Part A/B will NEVER pay for a wheelchair van. It is not a covered service by the statute, and there are no modifiers that would permit this charge. I have done ambulance billing and for over a decade, and owned my own service for 8 years.