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Does Medicare Cover Transportation for Dialysis?

Generally speaking, Original Medicare will not cover rides to and from dialysis appointments. However, it occasionally makes exceptions for individuals experiencing medical emergencies that would necessitate ambulance transport. Likewise, while 36% of Medicare Advantage plans in 2024 offer some transportation coverage, many still will not fully reimburse the frequent travel costs incurred from on-site dialysis treatment.

Kidney Disease Common in Older Adults 

Around 37 million Americans suffer from Chronic Kidney Disease (CKD). Because CKD patients often display minimal to no symptoms, many have little awareness of their condition until it advances to end-stage renal disease (ESRD), otherwise known as total kidney failure. 

To survive without an organ transplant, ESRD patients must undergo frequent courses of dialysis to help their bodies remove fluid and surplus waste products from the bloodstream. The most conventional treatment method, hemodialysis, utilizes an external filtration machine to act as an artificial kidney. Meanwhile, peritoneal dialysis requires a surgically implanted catheter to promote blood filtration through a patient’s stomach lining.

Limitations On How Original Medicare Covers Dialysis Transportation 

Original Medicare will never cover dialysis transportation outside of rare emergencies necessitating ambulance care. However, Original Medicare will pay for many of the supplies and services required to treat and manage ESRD, including:

  • Inpatient or outpatient dialysis treatment
  • Home dialysis training, equipment, and supplies
  • Laboratory tests
  • Certain drugs like heparin, topical anesthetics, and erythropoiesis-stimulating agents for ESRD-related anemia

Original Medicare even allows eligible ESRD patients to enroll in benefits before their 65th birthday, an exception only otherwise extended to people with ALS and other disabled individuals who have collected Social Security or Railroad Retirement Board disability insurance for at least 24 months.

Medicare Coverage For Home Dialysis 

Hemodialysis treatments typically must occur three times a week for nearly 4 hours per session, which often proves inconvenient for individuals who must travel to a dialysis center for care. To avoid this, many ESRD patients opt for in-home dialysis treatment. Because dialysis machines and supplies typically occupy ample space, you need access to a clean and spacious room. Likewise, you or your care partner must undergo procedural training before performing treatment independently.

If you have ESRD, Medicare Part B will pay 80% of the cost of training for you and your caregivers. A Medicare-certified dialysis center must provide the training, the dialysis machine, and the required supplies. Medicare will also cover dialysis-related services, such as equipment maintenance and repair, doctor visits, and help during emergencies. While Medicare will not pay for in-center dialysis care until after your third month of treatment, it will begin reimbursing costs on the first day of therapy for those who immediately start a home training program.

Medicare Coverage For Medical Transportation 

Original Medicare rarely covers non-emergency medical transportation (NEMT) services like routine doctor visits, rides to the pharmacy, and specialist appointments. However, exceptions occasionally occur. For example, Medicare Part B will cover ambulance transportation to the nearest hospital or health center required to treat an emergency condition or injury if any different mode of travel could endanger your health. 

Medicare Part B will only cover non-emergency ambulance transportation certified by a doctor as medically necessary. However, this allowance typically only applies to bedridden individuals or people who need essential medical services during their trip, such as professional administration of IV medications or monitoring of vital functions.

If you live in a skilled nursing facility (SNF), the SNF must pay for required ambulance transportation without billing Medicare. Notably, Medicare will never cover the services of “ambulettes,” wheelchair-accessible vans specially equipped for disabled or convalescent passengers. Likewise, it will never pay for ambulance transportation simply because a person lacks access to a convenient alternative. 

How Does Medicare Advantage Cover Transportation for Dialysis? 

Unlike Original Medicare, which receives federal funding, private companies fund and structure their Medicare Advantage policies independently. While all Medicare Advantage plans must legally offer minimum equivalent benefits to Original Medicare, many include additional services like dental care, grocery allowances, and non-emergency medical transportation. 

According to the KFF, 36% of standard Medicare Advantage plans and 88% of Medicare Advantage Special Needs Plans will cover non-emergency transportation services in 2024. Depending on your specific policy, this may include cab or bus fare to and from dialysis treatment. 

Alternative Options for Dialysis Transportation 

If your Medicare plan will not cover transportation to and from your dialysis facility, explore the following alternatives:

  • Local programs: Many states, cities, and communities support senior transportation programs (STPs) that provide fare assistance and public transit to eligible medical appointments. For example, Portland’s TriMet Lift Paratransit Service offers shared rides on city ambulettes to disabled individuals and seniors.  
  • Rideshare programs: Many popular rideshare programs have begun incorporating medical transportation services into their apps. For example, Uber Health and Lyft Healthcare will shuttle patients to and from appointments, pick up prescriptions, and deliver groceries on demand or at prescheduled intervals.
  • Charity and volunteer programs: Hundreds of donation-based organizations nationwide provide medical transportation to vulnerable individuals through the help of specially trained paid and volunteer drivers. For example, Seattle’s Hyde Shuttle Program and Portland’s Ride Connection offer door-to-door van service to seniors and disabled people who need transport to hot meal services, medical appointments, senior centers, and grocery stores.
  • Non-Emergency Medical Transportation (NEMT): Many Medicaid programs will cover medically necessary NEMT from taxis, cars, vans, public buses, and subways that meet their state’s specific guidelines. Contact your state Medicaid program to discover more about your options and how to schedule a pickup.

Putting It All Together 

Continuous treatment for kidney failure typically requires multiple weekly visits to a dialysis facility. While Original Medicare will not cover transportation for dialysis and other medical appointments, it will cover the cost of home dialysis training, treatment, and supplies. Likewise, some seniors can find free or low-cost NEMT coverage through Medicare Advantage, Medicaid, charity organizations, and city-run public transportation programs. 

Frequently Asked Questions

No. Whether you live in an urban, suburban, or rural area does not affect Medicare transportation requirements. As stated previously, Original Medicare does not typically provide NEMT benefits to patients commuting to and from regular doctor appointments, pharmacists, and dialysis facilities. 

While rural ESRD patients can still enroll in Medicare Advantage plans with NEMT benefits, non-urban districts often have limited to no standard public transportation services like taxis, subways, rideshare access, and public bus programs. Furthermore, driving to the nearest dialysis facility could take hours, making home treatment the most realistic option for many rural citizens.

No. Even if Medicare makes an exception for medically necessary or emergency reasons, you still must secure dialysis transportation through a Medicare-approved source like a city bus, a contracted rideshare company, or an ambulance. Save for emergencies, patients must always book covered trips in advance. If a friend or family member drives you to your dialysis appointment, you will likely have to pay for gas out-of-pocket.

Yes, though only in specific cases. Medicare will never cover ambulance transportation for stabilized ESRD patients simply because they lack another convenient travel alternative. For Medicare to cover ambulance transportation for dialysis, a patient must experience life-threatening kidney failure or other ESRD-related issues requiring immediate emergency care. Commuting in any vehicle other than an ambulance must also prove detrimental to the patient’s health.

Following a verifiable emergency, Medicare Part B will cover 80% of emergency ambulance transportation to the nearest hospital or dialysis facility and the cost of any drugs administered or medical equipment spent en route.

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