Yes, Medicare Part B may cover medically necessary transportation ordered by a doctor, and Medicare Part A may cover emergency transportation. However, Medicare Part A and B do not cover non-emergency transportation to and from your doctor's office.
Some Medicare Advantage plans may cover non-emergency transportation, such as trips to your doctor's office or clinic. Some Medicare Advantage plans also cover Lyft and Uber rides to and from your doctor's office or fitness center.
The only types of private Medicare plans that provides coverage for transportation are certain Medicare Advantage plans.
Medicare Advantage plans provide the same benefits as Medicare Part A and Part B combined into one simple plan.
In April 2018, the Centers for Medicare & Medicaid Services (CMS) announced it expand the list of benefits private insurance companies are allowed to cover as part of a Medicare Advantage plan.
The expanded Medicare Advantage benefits can include things like:
These extra benefits are offered as part of an aim to focus on more preventive health and aging-in-place benefits.
The popular ridesharing company Lyft recently announced plans to expand its collaboration with certain private insurance companies to provide non-emergency transportation to doctor’s offices, pharmacies, clinics and other health care facilities.
The company began partnering with private insurers to provide transportation to medical appointments for plan members who live in areas that lack public transportation.
Lyft later enhanced its efforts to include rides to pharmacies, and the most recent change will expand those services to hundreds of additional cities.
In a 2019 report released by Lyft, more than a quarter of Lyft riders (29 percent) said that the service helped them get to a medical appointment that they would have otherwise missed.1
And that’s not the only evidence to support the success of the partnership. One Medicare Advantage provider reported a 39 percent drop in ride costs and a 40 percent decrease in wait time for its patients after partnering with Lyft.2
Lyft is not only helping patients get to their appointments. The company is also helping qualified beneficiaries arrange other transportation.
Rides with Lyft are booked using a smartphone. But because many Americans over the age of 65 do not use smartphones, Lyft has been implementing upgrades to its Concierge feature, which allows businesses (like health insurance companies) to book rides for customers on their behalf.
With this feature, Medicare Advantage beneficiaries can arrange a Lyft ride through their insurer or a health care provider without having to use a smartphone.
Lyft will even begin offering rides to fitness centers as part of its partnership, as many Medicare Advantage plans include memberships to SilverSneakers and other wellness programs.
"We know that scaling investments and partnerships for innovative transportation models will improve health outcomes, decrease costs for patients, payers, and the government, and combat social isolation. We look forward to partnering with MA (Medicare Advantage) plans around the country to leverage the flexibility provided by CMS (Centers for Medicare and Medicaid Services) to test and make these new models a reality for patients." - Lyft3
Medicare Part B only covers non-emergency ambulance services to the nearest medical facility that is able to provide you with appropriate care if you have a written order from your doctor saying that it is medically necessary.
If you go to a facility that is farther away, Medicare’s coverage will be based on the charge to the closest facility, and you must pay the difference.
If the ambulance company thinks that Medicare might not cover your non-emergency ambulance service, they should provide you with an Advance Beneficiary Notice of Noncoverage.
Medicare covers emergency ambulance transportation if you’ve had a sudden medical emergency and your health is in danger.
Medicare may pay for emergency ambulance transportation by helicopter or airplane if your condition requires rapid transportation that cannot be provided on the ground.
Coverage for emergency ambulance transportation depends on the seriousness of your condition.
In some cases, Medicare may cover transportation in an ambulance if you have End-Stage Renal Disease (ESRD) and need ambulance transportation to and from the facility where you receive dialysis treatment.
If your ambulance service is covered by Medicare, Medicare Part B typically covers 80 percent of the Medicare-approved amount, and you pay 20 percent (once your deductible is met).
In 2020, the Medicare Part B deductible is $198 per year.
In order for transportation to be covered by Original Medicare, it must be ordered by a doctor.
For transportation to be covered by private Medicare insurance, it must be included in the plan’s benefits and fit within the parameters of any terms or conditions of the coverage outlined by the plan.
Contact your plan carrier to learn how your plan may cover transportation.
You can call to speak with a licensed insurance agent to find out if Medicare plans that cover transportation are available near you. You can also compare plan benefits online.
Medicare Supplement Insurance plans (also called Medigap) are sold by private insurance companies to work alongside your Original Medicare coverage.
A Medigap plan won't typically cover transportation, but a Medigap plan can help cover the out-of-pocket Medicare costs that you may face if Medicare covers your transportation.
For example, if your ambulance ride to the hospital is covered by Medicare Part B, some types of Medicare Supplement plans will cover your Part B deductible, and all Medigap plans provide at least some coverage for your Part B coinsurance costs.
Medicare Supplement plans and Medicare Advantage plans are very different things, and you cannot have a Medigap plan and a Medicare Advantage plan at the same time.
To learn more about your Medicare Advantage plan options and to compare plans that cover transportation that may be available where you live, call to speak with a licensed insurance agent today.
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