The transportation Medicare pays for can depend on the situation. Medicare typically covers emergency and nonemergency medical transport, as long as it is medically necessary and meets specific requirements.
Medicare Part B covers the ground or air ambulance services that a person may need in a medical emergency. In specific circumstances, Medicare may also cover nonemergency medical transportation.
This article explains how Medicare covers emergency and nonemergency medical transportation costs and under what circumstances the plan will generally approve coverage.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare Part B covers emergency and nonemergency ambulance services when they are medically necessary and other transportation could endanger a person’s health. In those cases, Medicare covers 80% of eligible transport costs.
A person may then have to pay the remaining 20% as coinsurance. The coinsurance will usually apply after a person pays the Part B deductible in full.
Medicare typically provides ambulance coverage to and from the following places:
| From | To |
|---|---|
| a hospital, skilled nursing facility (SNF), critical access hospital (CAH), or rural emergency hospital (REH) | a person’s home |
| a hospital, SNF, CAH, or REH | the nearest healthcare professional |
| a person’s home (roundtrip included) | the nearest appropriate renal dialysis facility, hospital, SNF, CAH, or REH |
Emergency transportation
Medicare Part B will typically cover ambulance services when:
- There is a sudden medical crisis.
- There is a severe risk to a person’s health.
- Moving a person from one location to another may be impossible without the help of the emergency services.
- A person is losing a lot of blood, is unconscious, or is in shock.
- An individual is set to receive a Medicare-covered service.
- A person is going to and from locations within the Medicare coverage guidelines.
- The ambulance service meets Medicare requirements.
Nonemergency transportation
A person can get nonemergency medical transportation covered by Medicare if they have a written order from a doctor stating that it is medically necessary.
This may happen when a person needs vital medical services during a trip, such as the monitoring of vital functions. This could also occur, for example, when a person requires dialysis on the way to the hospital.
A person may also need this when they are unable to:
- stand without assistance
- walk
- sit in a wheelchair or chair
Skilled nursing facilities and transport
If a person lives in a skilled nursing facility, Medicare may cover nonemergency trips.
A doctor must provide a letter to advise that travel is necessary, and when a person has Medicare Part A, the SNF should pay for transport costs.
The facility should not charge Medicare for transport services.
Ambulettes
Medicare does not cover ambulette services.
An ambulette is a van that can accommodate a wheelchair and provides nonemergency transport.
Emergency air transport
A person may need transportation by helicopter or airplane if they need immediate and rapid transportation that a ground ambulance cannot provide.
If a person is medically required to travel to the hospital by air, Medicare may pay for these services, provided that ground transport cannot reach the location due to:
- heavy traffic
- bad weather impacting the roads
- a distance that is too long to reach by ground in time to save the person’s life
Medicare Advantage covers the same benefits as Original Medicare but through private insurance companies. These plans must offer at least the same coverage as Original Medicare.
This means that people with Medicare Advantage would receive the same emergency and non-emergency transportation as they would under Original Medicare.
However, Medicare Advantage companies may require a person to choose in-network ambulance services to receive full reimbursement.
Nonemergency medical transportation
Nonemergency medical transportation helps people who need help getting to and from medical appointments.
It is primarily a benefit of the Medicaid program, but some Medicare Advantage plans also offer this benefit. A person can check with their specific Medicare Advantage plan to see if it offers nonemergency medical transport.
Supplemental transportation benefits
In 2019, the Centers for Medicare and Medicaid Services (CMS) expanded the abilities of Medicare Advantage companies to provide transportation for “primarily health-related” services.
This allows companies to include transportation for activities related to nutrition or wellness, such as a therapeutic massage appointment or a trip to the grocery store.
Ride-sharing companies, such as Lyft, have partnered with some Medicare Advantage programs to provide transportation.
Not all Medicare Advantage plans offer these extended transportation options, and they may differ from plan to plan. A person should call to learn the specific benefits of their plan.
When a person can, they may drive themselves or use public transportation to get to a medical appointment.
In cases when an individual who requires transport has a disability, is an older adult who no longer drives, or is someone with a lower income who does not have Medicare, they may be able to get medical transportation in the following ways:
- Nonemergency medical transport (NEMT): If people have Medicaid, they can use nonemergency medical transport.
- Taxis: People can use taxis or ride-sharing companies like Lyft and Uber. Transportation voucher programs may be available to help with the cost.
- Dial-a-ride: Dial-a-ride requires advance reservation and sharing the ride with others.
- Paratransit: Paratransit involves personal care assistants helping people with disabilities through the public transit system.
- Nonprofit organizations: Local transportation programs by nonprofit or religious organizations may assist with transport, help with the cost, or both.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Medicare Part B may cover emergency transport by road or air ambulance if a healthcare professional deems it medically necessary and under certain conditions.
Medicare may also consider coverage for nonemergency transport if a person is immobile or requires specific medication.
In most cases, a person may need a letter from a doctor stating that the ambulance or air transport is medically necessary.
Under some Medicare Advantage plans, a person may get certain additional medical transportation coverage. This is usually coverage for nonemergency transportation and may vary from plan to plan.
People who need it may also try to get additional non-Medicare transportation assistance and financial support. A person should check available resources in their area.