Not only does the potential of not being able to get anywhere throughout the day threaten the well-being of seniors and beneficiaries, but it can also prompt intense decisions about unpredictable costs and coverage. Although transportation to and from a doctor’s visit may not be covered by Medicare Part A and Part B, Advantage plans can help pay for rides to medical appointments. Additionally, local organizations may also assist with transportation to receive medical care.
Does Original Medicare Ever Pay for Transport to a Medical Visit?
In most instances, Part A and Part B of Medicare do not provide transportation for routine medical visits. However, emergency medical transportation to a hospital for an inpatient stay is covered by Medicare Part A. Also, Medicare Part B covers medically necessary outpatient procedures, including situations where you may be experiencing a medical emergency and need to be transported to a skilled nursing facility or hospital.
There are also instances in which transportation that is not related to an emergency can be covered. The criteria for non-emergency transport coverage include the following situations:
- It is necessary to have a physician diagnose or treat a medical condition.
- Alternative forms of transport could cause issues with your health.
- The physician submits a medical order in writing to show that transportation via ambulance is medically necessary.
- You don’t have a driver’s license,
- You cannot drive safely on your own.
If you have Medicare Advantage, your plan may cover your medical transport. You can check with your plan’s carrier to confirm medical transportation coverage.
Does Medicaid Pay for Transportation for Doctors’ Appointments?
Medicaid also has specific criteria that must be met to allow it to cover your transportation to a doctor’s appointment. They include the following situations:
- A health condition that makes it unsafe for you to wait for transportation for your visit.
- A health condition that makes it unsafe for you to drive.
- Lack of a working automobile.
- Lack of a driver’s license.
- No other means of transport available for the visit.
Does the Type of Transportation Matter to Medicaid?
If Medicaid provides your insurance coverage, your plan will determine the appropriateness of your selected transportation to your medical appointment. Each state determines its own rules for transport coverage.
Some of the types of transportation that may be covered by Medicaid include:
- Public buses
Keep in mind that some states such as South Carolina, Pennsylvania, and New Jersey, may require prior authorization to approve non-emergency transport by ambulance if:
- You have been transported at least three times within 10 days.
- You have been transported once weekly for at least three weeks.
Is Non-emergency Medical Transportation Available That is Not Related to Medicare?
If you do not meet the qualifications for non-emergency transport by ambulance, you may have other non-Medicare options, including:
- Local agencies: Organizations that may be in your city, such as Area Agency on Aging, may be able to assist you with your medical transportation needs. Additionally, you may find information about area transport services that are available to seniors by visiting eldercare.gov.
- Program of All-inclusive Care for the Elderly (PACE): PACE may be an additional option for rides to receive routine medical services. Visit www.Pace4you.org to learn more.
- Medicaid: If you qualify for Medicaid, your plan may cover rides for routine medical services.
Do Medicare Advantage Plans Cover Medical Transport Via Uber?
Ridesharing services such as Uber, have grown in popularity. As Uber has expanded, it has increased its services. In 2018, Uber launched a medical transport service called Uber Health. The service has partnered with over 1,000 organizations to make Uber medical transport a safe and less stressful experience for patients.
With the availability of Uber Health rides, some Medicare Advantage beneficiaries use Uber to travel to and from their doctors’ appointments. Although there are Medicare Advantage plans that cover Uber rides to medical visits, the coverage depends on the details of each particular Advantage plan. To verify whether your plan covers Uber for transport to doctor’s appointments, contact your Advantage plan insurer.
Do Medicare Advantage Plans Cover Lyft Rides to Medical Appointments?
Like Uber, Lyft is also a medical transport option for Medicare Advantage beneficiaries. Although every plan does not cover Lyft rides, multiple Advantage plans do. Lyft has collaborated with various insurance carriers to provide medical transportation for patients.
In 2016, Lyft added a non-emergency medical transport (NEMT) service. Prior to 2021, Lyft’s NEMT service was available to patients but only through sponsoring organizations. At that time, a patient could not schedule their own Lyft ride. Instead, a hospital or other organization had to contact Lyft and schedule the transport on the patient’s behalf. Now, patients can contact Lyft for non-emergency transport on their own.
With the new Lyft services, the cost of a medical ride and the wait time associated with non-emergency medical transportation has dropped. The services have been particularly helpful for beneficiaries in cities or towns that don’t have public transportation, such as buses.
If you are a senior with Medicare Advantage and are having trouble attending your medical appointments, contact your plan to determine your covered options.
- Uber Health 2020 Product Updates, Uber.