Getting to your hospital or doctor’s office can be an important element of receiving the healthcare you need. Here’s what you should know about Medicare transportation benefits.
Emergency Transportation with Medicare
Medicare Part B covers transportation service by ambulance in emergency situations where you need to reach a hospital, urgent care, or skilled nursing facility and cannot safely do so in another mode of transportation. Emergency transportation via airplane or helicopter may also be covered if rapid transportation is medically necessary.
Please be aware that Medicare will only cover transportation to the nearest facility that can appropriately care for you. For example, if you have a preferred hospital that’s not closest to where the ambulance picks you up, Medicare may not cover some of that ambulance bill.
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Non-Emergency Transportation with Medicare
Medicare Part B may cover non-emergency transportation via ambulance if it is medically necessary and your doctor provides a written order. Medicare Advantage plans, which are offered by private insurance companies, may include additional transportation service beyond what Medicare Part B includes. The scope of transportation covered varies by plan, but may include trips to and from:
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Doctor’s Offices
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Clinics
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Pharmacies
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Fitness Centers
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And more!
Some plans have partnered with rideshare services like Uber and Lyft to make this transportation more easily accessible as well.
However, transportation is still not a widely-available benefit for Medicare Advantage members. According to analysis by the Kaiser Family Foundation, about 43% of Medicare Advantage plans offer transportation benefits of some kind. Access is significantly higher in Special Needs Plans, with 88% of plans providing transportation benefits. Special Needs Plans are available to those who have Medicare and Medicaid both, have certain chronic illnesses, or reside in nursing facilities.
How Do I Access Medicare Transportation Benefits?
If you are already enrolled in a Medicare Advantage plan, you can contact your carrier or check your plan’s Summary of Benefits to see if any type of non-emergency transportation is covered. Alternatively, you can speak with a licensed health insurance agent who can check whether your plan includes those benefits.
If you don’t have transportation benefits and that is an important service for you, a licensed health insurance agent can help you find Medicare Advantage plans in your area that may offer transportation benefits. Please be aware that enrollment in Medicare Advantage plans is only available during certain times of the year. A licensed agent can let you know whether you’re eligible to enroll at any given time.
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Enrollment Eligibility
Annual Enrollment Period (AEP)
Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?
Initial Enrollment Period (IEP)
Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.
Special Enrollment Period (SEP)
You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.
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