Is Transportation Covered by Medicare?

Medicare is a federal health insurance program primarily for individuals aged 65 or older. It also extends coverage to certain younger people with disabilities and those diagnosed with End-Stage Renal Disease or Amyotrophic Lateral Sclerosis. It helps with healthcare costs but does not cover all medical expenses. Medicare’s transportation coverage is generally limited and specific, not a broad benefit for all medical appointments.

Medicare Part B Coverage for Ambulance Services

Medicare Part B covers ambulance services when medically necessary. This means that using other forms of transportation would endanger the patient’s health. Coverage is for transport to the nearest appropriate medical facility (e.g., hospital, skilled nursing facility, or dialysis center). If a patient chooses a facility farther away, Medicare generally covers only the cost to the closest appropriate facility, leaving the patient responsible for the difference.

Emergency ambulance services are covered for sudden, severe medical conditions requiring immediate attention, when an ambulance is the safest and fastest transport. Examples of such situations include unconsciousness, shock, severe bleeding, or conditions necessitating skilled medical care during transit. Medicare Part B covers 80% of the approved amount after the annual deductible ($257 in 2025) is met.

Non-emergency ambulance transport may also be covered if a physician certifies other forms of transport are medically contraindicated due to the patient’s condition. This can apply to individuals who are bed-bound, require continuous oxygen, or need stretcher transport. For scheduled non-emergency services, like frequent trips for dialysis, prior authorization from Medicare may be required. Without approval, Medicare may deny coverage, making the patient responsible.

Air ambulance services (airplane or helicopter) are covered only in limited circumstances when ground transport is not feasible or medically appropriate. This includes situations where the pickup location is inaccessible by ground vehicle, or when long distances or heavy traffic would delay critical care. The patient’s condition must necessitate immediate, rapid transport that ground ambulance cannot provide, threatening survival or seriously endangering health. Air ambulance costs are substantial, often ranging from $12,000 to $25,000 for a 52-mile flight, with Medicare covering 80% after the deductible.

Non-Ambulance Medical Transportation

Original Medicare (Parts A and B) generally does not cover routine, non-emergency transportation to medical appointments (e.g., cars, taxis, or buses). This includes trips to doctor’s offices, pharmacies, or other healthcare services. Beneficiaries are typically responsible for the full cost of these services unless other resources are available.

Limited exceptions exist where non-ambulance transportation might be covered indirectly or through specific programs. Some state Medicaid programs offer non-emergency medical transportation benefits for dual-eligible individuals (qualifying for both Medicare and Medicaid). These state-specific programs can provide rides to medical appointments for eligible beneficiaries who have no other means of transport.

In rare instances, Medicare might cover stretcher-van services if they are medically necessary and an ambulance is not required. However, this coverage is highly restrictive and often aligns with the strict criteria for non-emergency ambulance transport, requiring a physician’s order. The primary focus of Original Medicare’s transportation coverage remains emergency or medically necessary ambulance services, leaving routine non-emergency travel largely uncovered.

Transportation Benefits Through Medicare Advantage Plans

Medicare Advantage plans, also known as Medicare Part C, are offered by private insurance companies approved by Medicare. These plans are required to cover all benefits included in Original Medicare (Parts A and B). A significant feature of Medicare Advantage plans is their ability to offer additional benefits that Original Medicare does not cover, with non-emergency medical transportation being a common example.

These transportation benefits vary considerably depending on the specific plan, its location, and the associated premiums. Such benefits often include scheduled rides to doctor appointments, urgent care centers, or pharmacies. Some plans may even cover transportation to fitness centers for approved wellness programs.

Transportation services through Medicare Advantage plans are typically provided via the plan’s specific network of transportation providers. Prior authorization or scheduling through the plan is usually required to access these services. It is important for individuals to review the specific benefits of their Medicare Advantage plan to understand the extent and conditions of transportation coverage. This ensures they are aware of what is covered and how to access these supplemental benefits.