Does Medicare Cover Transportation to Dialysis?
Most seniors today hate the idea of losing their independence, and they work hard to maintain it for as long as possible. But for many, giving up the keys to the car and asking for help to get around will be inevitable at some point.
If you rely on driving yourself to and from important medical appointments or to complete daily chore, you should be aware of some common health conditions that could hamper your ability to drive, temporarily or permanently, such as:
- Impaired vision or hearing
- Parkinson’s disease
- Arthritis
- Diabetes
- Taking certain medications
- Injury or illness
- Medical procedures like outpatient surgery or kidney dialysis
Patients who are on kidney dialysis should have someone available to drive them to treatment sessions (and home again) which are usually three times a week. You might think that you can manage it yourself, but you won’t always feel up to driving home after treatment due to blood pressure abnormalities, feeling fatigued, or other reasons. If you don’t have a family member or friend to rely on for your trips to dialysis, you may need to use a transportation service.
Does Medicare cover transportation to and from dialysis appointments?
If you are enrolled in Medicare, or you’re eligible for Medicare insurance and you have end-stage renal disease (ESRD), you have coverage for the following:
- Inpatient dialysis treatments that are covered by Original Medicare Part A
- Outpatient dialysis treatments and physician services are covered by Original Medicare Part B (either at a Medicare-affiliated dialysis facility or in your own home)
- Home dialysis training, equipment, supplies, and support services if you’re a candidate for home dialysis
- Certain prescription drugs
- Miscellaneous services and supplies
Unfortunately, Original Medicare doesn’t provide regular transport to and from dialysis treatment sessions, as a rule. However, in some instances, Medicare might pay for non-emergency ambulance transport if you get a written order from your physician certifying that it is medically necessary.
While you may qualify for Medicare-covered transport to dialysis on occasion, the benefit is only available on a limited basis. Original Medicare Part B pays 80 percent of the final approved cost for non-emergency, medically necessary transport by ambulance. You pay the remaining 20 percent of the cost after covering your annual Part B deductible.
If you have coverage through a Medicare Advantage (Part C)plan, you may have additional coverage that’s not available through Original Medicare. These days, over 33 percent of available Medicare Advantage plans offer transportation benefits for enrollees.
Because Medicare Advantage plans are sold by Medicare-affiliated private insurance companies, providers have the option to include additional and extra benefits, so check with your plan to see if they include transportation benefits. Your Medicare Advantage plan may also require that you use plan-approved dialysis centers to get your coverage, so ask a representative for details before making medical appointments.