Non-Emergency Medical Transportation (NEMT) can be an expensive service. Especially if you have to utilize it regularly for things like doctor appointments. There are several ways to help offset those costs, one of which is Medicare. Typically for individuals over the age of 65 or individuals with disabilities, a little over 19% of the U.S. population relies on Medicare to offset the cost of their medical expenses.
Does Medicare cover the cost of NEMT. The short answer is maybe. Not all Medicare programs are the same, and depending on which you have, NEMT may or may not be covered. Within the different types of Medicare, there are also different criteria that need to be met in order for NEMT to be covered.
Medicare Coverage for NEMT
There are three different types of Medicare that could possibly cover the cost of NEMT, Medicare Part A, Medicare Part B, and Medicare Advantage. They each offer different types of coverage to beneficiaries. They also all differ on whether or not the cover NEMT.
Medicare Part A
Generally, Part A is for inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. This type of Medicare does not typically cover the cost of NEMT.
Medicare Part B
Part B helps cover the cost of services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and preventative services. There are certain circumstances when Part B will cover the cost of NEMT. Namely, when it is deemed medically necessary and with a doctor’s written order.
Medicare Advantage
Also known as Medicare Part C, Medicare Advantage is an alternative to Parts A and B and is offered by private insurance companies approved by Medicare. Advantage plans bundle hospital and medical coverage, offering a wider range of services than just Part A or Part B. Some Medicare Advantage Plans will include coverage for NEMT. This is typically not covered by Parts A and B and is usually added as an additional benefit.
How Do I Know If Medicare Will Cover My NEMT?
Medicare plans can be complex and sometimes confusing. The best way to find out if your Medicare plan covers NEMT is to look at Medicare’s official resources or talk with your healthcare provider. For Medicare Advantage plans, you can review your plan’s benefits summary or contact your Medicare Advantage plan provider directly.
Empower Your Riders with NEMT Software
Sometimes, emergency transit isn’t the best solution. When that happens, riders need viable alternatives so they can get to appointments and stay active in their own health. NEMT fills that gap while elevating riders’ independence, peace of mind, and more. Want to help them get there? Let Ecolane’s NEMT software power your agency’s non-emergency ride service. Schedule a demo today to see how it works.
