Original Medicare generally does not pay for routine rides to medical appointments simply because a patient needs transportation. Medicare Part B primarily covers ambulance transportation when transporting the patient another way could endanger the patient's health.
What transportation does Original Medicare cover?
Medicare Part B covers medically necessary ambulance services when traveling by another type of vehicle could put the patient's health at risk.
In limited situations, Medicare may also cover non-emergency ambulance transportation when it is medically necessary and certain requirements are met. A healthcare provider may need to document that ambulance transportation is required.
That is different from ordinary NEMT transportation in a passenger or wheelchair-accessible van.
Does Medicare pay for rides to regular appointments?
Usually not through Original Medicare.
A routine ride to a doctor's appointment, therapy visit, dialysis appointment, or other healthcare destination is not automatically covered simply because the passenger has Medicare.
What about Medicare Advantage?
Medicare Advantage plans can have different benefits and rules than Original Medicare. Some plans may offer additional transportation benefits.
Because benefits vary by plan, members should contact the phone number on their insurance card and ask:
Do I have a transportation benefit?
What types of appointments qualify?
How many rides are included?
Who schedules the transportation?
Do I have to use a specific transportation company?
Can I still use NEMT if Medicare does not cover it?
Yes.
Many families arrange private-pay NEMT when Medicare does not provide a transportation benefit.
A family member, senior living community, healthcare facility, or the passenger can hire a transportation company directly and pay for the service.
What if I need medical care during the ride?
If your medical condition requires monitoring, treatment, or ambulance-level care during transportation, speak with your healthcare provider about the appropriate transportation option.
NEMT is designed for medically stable passengers who do not require emergency medical care during the ride.
Looking for private-pay transportation?
Magnolia Signature Care provides non-emergency transportation for seniors, families, and healthcare organizations throughout the Triangle.