The older we get, the more often we tend to visit the doctor. Depending on your health situation, it may not be safe (or possible) for you to drive yourself there. When you need a ride and your normal chauffeur is unavailable, will you call an uber? This can get expensive if you make frequent trips to see your doc. A common question asked among beneficiaries is: Do Medicare plans cover transportation for medical purposes? Let’s dive into it.
Medicare Transportation Coverage in a Nutshell
If you need to be transported to a doctor’s appointment, Original Medicare (A and B) will typically not cover this service. However, some Medicare Advantage plans cover transportation for medical reasons.
Also, you may be able to get non-Medicare transportation to doctors appointments — through certain organizations, like your local Area Agency on Aging (AAA).
Original Medicare and Transportation
Original Medicare is Part A and Part B, which usually doesn’t cover transportation to get standard health care.
But it may cover non-emergency transportation via ambulance — to and from a medical service provider. You just need to meet some requirements. First, you must have a health condition diagnosed or treated, and other transportation methods could jeopardize your health. Next, your doctor must submit a written order confirming that ambulance transportation is “medically necessary” due to your health condition.
Rules Will Vary By State
If you use an ambulance company based in Pennsylvania, South Carolina, or New Jersey, you may be impacted by prior authorization rules — if you need non-emergency, medically necessary ambulance services:
- Three or more times over a 10-day stretch, OR
- At least once a week for three or more weeks.
To see if these rules apply to you, call Medicare at 1-800-633-4227 (TTY users, dial 1-877-486-2048). This is a 24/7 phone line.
Related Post: Can You Get Medicare Coverage in Another State?
What Non-Medicare Transportation Options Could Be Available?
For users who don’t qualify for non-emergency ambulance transportation, there may be non-Medicare transportation services available in their area through local groups. An example would be the AAA, as we mentioned earlier in this article. This organization might be able to help you secure transportation to and from your medical provider. To find a State and/or Area Agency on Aging, go to their website.
If you’re eligible for Medicaid or PACE, these groups may also provide transportation for standard medical care. You can go to www.Medicaid.gov or www.Pace4you.org for more info.
Medicare Advantage and Transportation
As of 2020, Medicare Advantage programs are allowed to offer innovation benefits, including transportation to a doctor’s office. Medicare Advantage is essentially an all-in-one alternative to Original Medicare — so you get the same Part A and Part B benefits, and then some. You buy these plans through a private, Medicare-approved insurer or through a licensed, independent agent like TSS.
How it generally works: Rides are included with your plan at no additional cost. Your plan will cover you for a certain number of one-way trips, with up to a certain mileage per trip (it may be around 60 miles).
Related Post: Do I Need to Pack My Medicare Card While I Travel?
Are you looking for a Medicare Advantage plan that may cover transportation? Call Trusted Senior Specialists at (855) 952-1941. We’ll tell you what’s available in your area.
