Taking care of your health is a top priority. This means regular trips to see medical professionals for ongoing, non-emergency care. Whether it’s doctor visits, trips to the pharmacy, physical therapy, or other healthcare facilities, you need a reliable way to get there. 

While some seniors can drive themselves or have a spouse or child who can pitch in, others are reliant on friends and neighbors. And as you well know, things can and often do come up. 

Whether it’s your physician who has an emergency and must move the appointment a few hours or days, or a grandchild who unexpectedly needs to be picked up from school. Suddenly your best-laid plans have changed and there’s no one to drive you. Your appointment has to be postponed or canceled, and your good health is put on hold. Thankfully, there are resources, like Medicare Advantage, that can help.

Before we dive deeper, it’s important to note that these services are for non-emergency health matters. If someone’s life is at risk, it’s essential that you dial 911 to get immediate care.

Medicare Appointment Transportation: Special Circumstances

While Medicare (Part A and B) can cover certain non-emergency medical transportation needs, these are primarily reserved for those whose health conditions require specialized care. For example, non-emergency ambulatory services for seniors who can’t risk exposure to other forms of transportation. Such circumstances must be specified by your physician in writing, confirming that your medical condition necessitates it.

Some seniors will qualify for PACE (Program of All-Inclusive Care for the Elderly) or Medicaid. These programs have their own transportation guidelines and services for those enrolled. 

To qualify for PACE, you must:

  • Be age 55 years or older
  • Live within a PACE organization’s service area
  • Be certified by the state where you live as requiring a nursing home level of care
  • Be able to safely live in your community with PACE’s assistance

To learn more, visit www.pace4you.org 

For those enrolled in Medicaid, non-emergency medical transportation assistance may be provided if you meet the eligibility requirements of your state. These might include not having a driver’s license, not owning a working vehicle, having a disability (mental or physical), or being incapable of taking transportation alone. Visit medicaid.gov to learn more.

Non Emergency Medical Transportation for Seniors

What if you’re a senior who doesn’t fall into any of the groups mentioned above? You still need help getting access to the ongoing health services you require. As of 2020, many Medicare Advantage plans have begun offering new benefits to assist with this urgent need. And, depending upon the specifics of your plan, you may be able to take trips to not only physician visits, but also pharmacies, physical therapy appointments, and more.

As with any provider, it’s important to know what options are available so you can choose the one that will best suit your circumstances. Here are a few of the key features to examine, which vary according to each plan:

  • Is this transportation service included free, as a part of the Medicare Advantage plan, or is there an added fee?
    Some plans will include this ride benefit at no additional charge. 
  • Which types of non-emergency medical services are approved for Medicare transportation?
    These may include physician appointments, lab tests, pharmacies, physical therapy appointments, visits to health club facilities, etc. Each plan will have a specified list of approved provider types.
  • How many one-way trips are covered?
    Is there a maximum number allowed within a specified timeframe? Some offer unlimited trips, while others have a cap. Take into consideration whether you will have physical therapy or other ongoing treatment needs. Perhaps you have made arrangements to be regularly dropped off by someone but will need transportation back home. In this case, it would count as one trip, rather than two.
    • What is the maximum number of miles allowed per trip? 
      Will this plan enable you to regularly visit the facilities you wish to access? While some plans place no limits on mileage, others set a maximum mileage per trip. For example, a maximum of 25 miles or even 60 miles each way. The good news is that with all Medicare Advantage providers, if your destination falls outside the transportation mileage limit, some special exceptions can be made.
    • Which transportation services are authorized to serve in your area?
      Some partner with ride-sharing services while others work with taxi or van services.
  • What hours/days will the service be available?
    Ensure that it will enable you to reach your destination(s) and return home as needed.

Non-Medicare Transportation Options

If you would like to learn about potential non-Medicare resources in your area that can assist with locating medical transportation for seniors, you may wish to contact your local Area Agency on Aging. You can search for contacts in your region using the Eldercare Locator

Make Your Plan Today

Regardless of which program you choose, be sure you have a transportation plan in place. Ensuring you have the health care you need has never been more important. And transportation should not stand in the way of receiving it. 

If you’re driving yourself or relying on one or two close relatives or friends to assist you, keep in mind that circumstances can change over time. When it’s time to hang up your keys for good, or your driver moves away, you won’t want to be left wanting. Give yourself the peace of mind of knowing you have your bases covered. You’ll be so glad you did!