Medical transportation is available through government insurance programs, local transit agencies, veteran services, and community organizations, often at low cost or free. The program you qualify for depends on your insurance, disability status, income, and where you live. Here’s how each option works and how to access it.
Medicaid Covers Transportation as a Required Benefit
If you have Medicaid, you already have a transportation benefit. Federal law requires every state Medicaid program to provide non-emergency medical transportation (NEMT) to get enrollees to and from covered appointments. This includes medical, dental, vision, behavioral health visits, and even prescription pickups after a doctor’s appointment.
Each state runs its program differently. Most contract with a transportation broker, a company that coordinates rides on the state’s behalf. To book a ride, you typically call the broker’s phone number (printed on your Medicaid card or found on your state Medicaid website) and provide your Medicaid ID number, the provider’s name and address, and your appointment date and time. You’ll need to call at least 48 hours (two business days) before your appointment. Trips over 75 miles one way generally require prior authorization.
The catch: Medicaid transportation is considered a last resort. You’re expected to use it only when you have no car, can’t drive, have no family or friends who can take you, and don’t live on a bus route. A medical provider may need to complete a certification form confirming your transportation is medically necessary, especially for recurring trips or specialized vehicles like wheelchair vans.
Medicare Covers Ambulance Rides, Not Routine Trips
Medicare does not cover routine rides to doctor appointments. What it does cover, under Part B, is ambulance transportation when traveling in any other vehicle would endanger your health. That includes emergency ground ambulances to the nearest appropriate hospital or facility, and in some cases helicopter or airplane transport when ground transport can’t get you there fast enough.
Medicare also covers non-emergency ambulance rides if your doctor writes an order stating the ambulance is medically necessary. A common example: someone with end-stage renal disease who needs ambulance-level transport to dialysis. If you’re getting scheduled ambulance rides three or more round trips in a 10-day stretch, or weekly for three or more weeks, a prior authorization program may kick in before the fourth trip in a 30-day period.
After your Part B deductible, you pay 20% of the Medicare-approved amount. For getting to routine appointments, Medicare beneficiaries typically need to look at other options on this list.
VA Travel Benefits for Eligible Veterans
Veterans can get mileage reimbursement or arranged transportation to VA health facilities and VA-approved community providers. You’re eligible if at least one of these applies to you:
- You have a VA disability rating of 30% or higher
- You’re traveling for treatment of a service-connected condition
- You receive a VA pension
- Your income falls below the maximum annual VA pension rate
- You can’t afford to pay for travel under VA guidelines
- You’re traveling for a compensation and pension exam, to get a service dog, or for VA-approved transplant care
If your medical condition requires an ambulance or specially equipped vehicle, the VA may cover that too, but it needs to be approved in advance by a VA provider (unless it’s an emergency). You can file travel pay reimbursement claims online through the VA website or at a VA facility after your appointment.
One thing to know: if you use a free ride service like the Disabled American Veterans (DAV) transportation network or a VA Veterans Transportation Program shuttle, you can’t also claim travel pay reimbursement, since there are no out-of-pocket expenses to reimburse.
Paratransit Services Under the ADA
If you have a disability that prevents you from using regular public buses or trains, your local transit agency is required to offer paratransit service. This is a shared-ride, door-to-door service that operates during the same hours as regular transit routes and covers destinations within three-quarters of a mile on each side of any existing fixed route.
Eligibility isn’t based on your diagnosis alone. The transit agency evaluates whether you can functionally use the fixed-route system given your specific circumstances. You’ll go through an application process that may involve an in-person assessment. Once approved, you can use paratransit for any trip, not just medical appointments, and you can chain multiple stops in a single day just like a regular bus rider would.
Paratransit fares are capped at no more than twice the regular bus fare. For recurring medical trips like dialysis, you can set up subscription service so you don’t have to call and rebook every time. Transit agencies can allocate up to 50% of their available rides at a given time to subscription service.
Levels of Service: What Type of Ride Do You Need?
Medical transportation isn’t one-size-fits-all. When you book, you’ll be matched with a level of service based on your mobility and medical needs:
- Curb-to-curb: The driver meets you at the curb. You get in and out of the vehicle on your own.
- Curb-to-curb with assistance: The driver helps with minimal tasks like securing a wheelchair in the vehicle or stowing a walker.
- Door-to-door: The driver walks you from your front door to the vehicle and from the vehicle to the facility entrance.
- Door-through-door: The driver assists you from inside your home to the vehicle and from the vehicle to inside the facility.
- Hand-to-hand: The driver physically hands you off to a caregiver or staff member at both pickup and drop-off.
- Stretcher transport: You’re transported lying down, with assistance transferring to and from the stretcher.
Getting the right level matters. If you request curb-to-curb but actually need door-through-door help, you could end up stranded. Be honest about your mobility when booking, and make sure your doctor’s certification form reflects your actual needs.
Paying Out of Pocket
If you don’t qualify for any program or need a ride on short notice, private-pay non-emergency medical transport is available in most areas. Current rates vary by the type of vehicle you need:
- Ambulatory (walk-on): $50 to $100 per trip
- Wheelchair van: $100 to $250 per trip
- Stretcher van: $200 to $450 per trip
- Bariatric transport: $300 to $600 or more per trip
Most companies also charge a mileage add-on of $2.50 to $5.00 per mile on top of the base rate. For a wheelchair van trip of 20 miles, you might pay $150 to $350 total. Search for “non-emergency medical transportation” plus your city to find local providers, and get quotes from at least two or three before booking.
Free and Low-Cost Community Programs
Volunteer driver programs fill an important gap, especially in rural areas and for seniors. These are typically run by faith-based organizations, nonprofits, or local transit agencies. A sponsoring organization recruits drivers, runs background checks, handles scheduling, and sometimes reimburses drivers at the federal mileage rate.
The American Cancer Society’s Road to Recovery program is one of the most well-known examples, providing free rides to and from cancer treatment for people who can’t drive themselves or don’t have a ride. Many counties run their own versions. Vernon County, Wisconsin, for instance, operates a volunteer driver program open to all residents with copayments based on mileage, and passengers who need extra help can bring an attendant at no charge.
Programs like the New Freedom Transportation Program specifically serve elderly people and those with disabilities, covering medical appointments as well as shopping and social activities. To find what’s available near you, call your local Area Agency on Aging (reach them through the Eldercare Locator at 1-800-677-1116) or dial 2-1-1, which connects you to community services in most parts of the country.
How to Start
Your first step depends on your insurance. If you have Medicaid, call the number on your card and ask about transportation services. If you have Medicare, ask your doctor whether your situation qualifies for ambulance coverage, and explore paratransit or community programs for routine visits. Veterans should contact their local VA medical center’s travel office. If you have no insurance or your plan doesn’t cover transport, check with 2-1-1, your Area Agency on Aging, or local nonprofits before paying out of pocket. Many people qualify for free or subsidized rides and simply don’t know the benefit exists.