What You Need to Know about Transportation and Medicare and Medicaid Plans

Angela Damiano

Millions of Americans are covered by Medicare and Medicaid insurance, but when it comes to covered transportation, few people are aware of the differences in availability and cost. According to the Centers for Medicare & Medicaid Services, over 55 million Americans are covered by Medicare and over 70 million are covered by Medicaid. It is important to highlight the differences in transportation between these two plans.

Medicare and Medicaid Programs

Despite both Medicaid and Medicare being government programs, the source of funding for each is different. Medicaid services low-income populations and relies primarily on state funding. This results in different levels of coverage and reimbursement rates by state, and Medicaid generally covers significantly fewer services than other sources of insurance. Medicare is a federal program for the aged population of the United States, regardless of income. Because Medicare is a federal program, billing and services offered are significantly more consistent across the country (with small adjustments based on the cost of living), especially when discussing medical transportation

When it comes to transportation, however, Medicaid covers a lot more than Medicare. Medicaid will pay for eligible non-emergency trips for patients who can walk, use a wheelchair, or require a stretcher or ambulance. Medicare, however, will only cover eligible non-emergency trips if a patient requires an ambulance.

Reimbursement Differences

Reimbursement for Medicaid services varies by state, while Medicare is generally consistent across the country and always the same within defined geographic regions. For example, transportation providers in states like New Jersey have bargaining power with the state transportation broker. As a result, Medicaid rates can vary by transportation provider, by geography, and over time.

On average, Medicaid reimburses transportation providers only 61% of what Medicare will reimburse for an ambulance trip. This holds true across New England, including the Delaware Valley area where Roundtrip is beginning operations.

The Role of Roundtrip

Roundtrip can accommodate booking trips for patients with any payment provider, including Medicare and Medicaid. By improving vehicle utilization and increasing routing and scheduling efficiencies, Roundtrip looks to alleviate pressures currently on the Medicaid and Medicare transportation system.