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New Payment Model for Medicare Transportation

By  Senior Market Advisors  on February 18, 2019

Transportation has been a popular topic in the healthcare industry. Medicare Advantage plans are offering new transportation benefits and CMS has plans to experiment with a new payment model for Medicare transportation.

Current Payment Model

Currently, Medicare only covers emergency ambulance transportation to a hospital or skilled nursing facility if transporting in a different vehicle would put a beneficiary’s health at risk. Medicare may cover non-emergency transportation in an ambulance if a beneficiary has a written doctor’s note explaining why an ambulance is medically necessary. What about transportation to a doctor’s office or an urgent care facility?

The current payment model creates the wrong incentive for first responders and pushes beneficiaries into the most high-cost setting. Plus, it fills emergency rooms with people who don’t need emergency care.

Future of Medicare Transporation

Medicare wants to give more options to seniors and Medicare eligibles than the emergency room. This includes urgent care centers, doctor offices, and even home treatment through telehealth! They are testing the idea on a smaller scale before committing and adopting the idea nationwide. If they choose to move the program nationally, Medicare could save more than $500 million annually.

In this test model, ambulances will still get paid for transporting a patient to the ER. However, they will be reimbursed the same amount if they transport a patient to an alternative care option like a 24-hour urgent care facility. They will also be paid if they choose to partner with a health provider that provides treatment on-scene through telehealth. This model could help cut costs and provide patients with the type of care they need.

Medicare Advantage and Medicare Transportation

Sometimes, Medicare Advantage plans cover non-emergency transportation through the ride-sharing market with companies like Lyft and Uber. Not all plans offer this benefit, but it is a great selling point when you are talking with beneficiaries.

Lyft has plans to create a “no-cost” service that provides insured transportation to and from health appointments. Lyft Concierge is a website that allows beneficiaries to schedule or book a ride from a computer alongside their plan’s coverage. Uber will allow parents, caregivers, and medical staff to schedule transportation on their behalf. Plus, Uber has created “Uber Health” which is a HIPAA compliant and cost-effective way for beneficiaries to book rides with their plan’s coverage.

Sell Medicare Advantage

The new payment model will not be finalized for some time, if at all. As always, this industry will continue to evolve, and we make sure our agents are prepared and equipped to make the most sales! We offer an experienced in-house marketing team, sales support team, and top-tier commissions. Ready to contract? Visit to start digitally contracting!