Getting Medicare Advantage transportation trips: supplemental benefits and the vendors behind them

Where Medicare Advantage rides come from

Medicare Advantage transportation is an extra benefit, not a Medicare requirement. Original Medicare does not pay for routine rides to appointments, as our guide on what Medicare covers explains. A Medicare Advantage plan can add them.

CMS says it plainly in Chapter 4 of the Medicare Managed Care Manual: a plan is not obligated to provide transportation to non-emergency Part A and Part B services, but it may offer transportation as a supplemental benefit. The same section sets three limits:

• The rides must serve the member’s health care needs, such as doctor visits.
• The plan must arrange the rides or provide them directly.
• The plan must describe the benefit in the plan benefit package it files with CMS.

A second, narrower channel exists for members with serious chronic illness. Under 42 CFR 422.102(f), a plan can offer special supplemental benefits for the chronically ill (SSBCI), and these may reach beyond health care. CMS’s April 2019 guidance names rides for non-medical errands, such as grocery shopping and banking, as one such benefit. Only members who meet all three parts of the rule qualify: a medically complex chronic condition, a high chance of hospital stays or other adverse outcomes, and a condition that “requires intensive care coordination.”

How common the benefit is in 2026

Ride benefits are most common in special needs plans, and both plan types offered them less often in 2026 than in 2025. KFF’s analysis of 2026 plan offerings, published in December 2025, counts the share of plans that include each benefit:

For a provider, the takeaway is where to look. Special Needs Plans are the most likely to have the benefit, while only about one general plan in four includes it.

One source of extra benefits has also closed. CMS’s Value-Based Insurance Design model let participating plans target added benefits, such as rides to medical appointments, to members with chronic conditions or low incomes. The model ended on December 31, 2025, so any ride benefit in a 2026 plan comes through the regular supplemental benefit rules above.

Trip caps and plan rules

Each plan writes its own caps, and the two below count one-way trips. Both are 2026 plans for members who also have Medicaid:

Three rules follow from caps like these:

1. A round trip spends two trips. A member with 24 trips has 12 appointments’ worth of rides a year.
2. Members run out. A regular rider can use up the year’s trips before December, and the plan covers no more after that.
3. The vendor authorizes each ride. Run only trips the vendor assigned. A ride the member books with you directly is not a plan trip.

A plan can rewrite its benefits each January 1. The trip count, the allowed destinations, and even the vendor can differ from one year to the next.

Dual eligible plans: two payers behind one rider

Members enrolled in both programs often sit in a D-SNP, the dual eligible special needs plan. Under 42 CFR 422.2, a D-SNP coordinates the two programs’ services for its members, holds a contract with the state Medicaid agency, and may cover some Medicaid services itself.

That creates two possible payers for the same rider. CMS’s Medicaid transportation guide, SMD 23-006, makes Medicare the primary payer for services both programs cover. It also keeps the state on the hook for the ride whenever a full-benefit dual eligible member travels to a Medicaid-coverable service, with Medicare paying first for the service itself. Trips to fill Part D prescriptions are a state option, not a requirement.

Both example plans show the two layers side by side. ATRIO’s summary lists 24 plan-covered routine trips, and a separate section lists medical transportation under the Oregon Health Plan, Oregon’s Medicaid program. VIVA’s summary does the same with Alabama Medicaid’s non-emergency transportation, which needs prior approval. The same rider could reach you through the plan’s vendor or through the state’s Medicaid transportation program.

The most integrated plans can go further. Under 42 CFR 422.102(e), fully integrated and highly integrated D-SNPs that meet quality standards may offer additional supplemental benefits, with CMS approval.

In practice, bill the source that booked the ride. A trip from the plan’s vendor goes back to that vendor. A trip from the Medicaid broker goes to the broker. Never bill both for the same ride.

Who manages the rides

Plans often do not run transportation themselves. They contract a transportation vendor, and the vendor recruits, credentials, and pays providers. Recent examples:

The large vendors court these plans openly. Modivcare markets its services to Medicare Advantage plans and stresses their value for dual eligible and special needs members, and MTM Health describes managing transportation benefits for both Medicaid and Medicare programs. Alivi serves as the transportation vendor for Wellcare members.

Vendors add their own rules to the plan’s. On Alivi’s Wellcare page, members book between 72 hours (3 business days) and 30 days ahead of an appointment. When a will-call member phones to come home, the assigned company has 60 minutes to arrive, so a provider in that network has to keep a van free for those calls.

The HealthSpring switch shows why this matters. When a plan changes vendors, its trips move with it. A provider that only worked with the outgoing vendor loses those trips on the switch date, while one already in the incoming vendor’s network picks them up. Our guide to NEMT broker transitions covers how to prepare.

What the Medicare rules pass down to you

When a vendor holds the plan’s transportation contract, the companies it sends trips to are downstream entities under the plan’s contract with CMS. 42 CFR 422.504(i) says the plan stays responsible for everything it delegates, and it must require every downstream entity to agree to these terms:

• Audit access. HHS, the Comptroller General, or their designees can audit your books, contracts, and records related to the plan, for 10 years after the contract period ends or an audit finishes, whichever is later.
• Preclusion list. No payments go to people or entities on Medicare’s preclusion list.
• Member protection. You cannot hold a member liable for fees that are the plan’s obligation.
• Monitoring. Your performance is monitored on an ongoing basis, and the delegation can be revoked if you do not perform.

Vendors turn those rules into paperwork. Alivi’s published downstream provider policy requires a signed attestation before a provider starts and every year after. Its topics include a code of conduct, compliance and fraud, waste, and abuse training, screening against the OIG and SAM exclusion lists, HIPAA privacy and security, record retention, background screening, and ownership disclosure. Alivi audits at least 5 percent of its active downstream providers each year.

Build that into your routine:

1. Screen every driver and office employee against the OIG exclusion list and SAM when you hire them and again at set intervals, and file the results.
2. Keep a dated record of each person’s yearly compliance training.
3. Hold trip records, driver files, and billing records for 10 years, the length of the federal audit window.
4. Keep ownership and management information current with each vendor.

How to get into Medicare Advantage networks

1. Map the plans sold in your counties. Medicare Plan Finder shows the plans sold in each ZIP code, and each plan’s Summary of Benefits lists any ride benefit. Start with D-SNPs and other special needs plans.
2. Find each plan’s vendor. Plan provider notices, quick reference guides, and member summaries often name it. A line such as “must use SafeRide” answers the question.
3. Apply to the vendor’s network. MTM, for example, recruits commercial transportation providers in multiple markets and keeps applications on file when an area has no immediate need. Our guide to NEMT broker contracts covers the application itself.
4. Pass credentialing. Expect insurance certificates, vehicle and driver documents, the Medicare compliance attestation, and exclusion checks.
5. Offer wheelchair and stretcher capacity if you can. Alivi’s Wellcare page lists wheelchair and stretcher trips as well as two ambulatory levels, curb-to-curb and door-to-door. A fleet that covers several of those is easier to place in a network.
6. Settle the terms before the first trip. Get prices for every service level in writing, along with where paid mileage starts, whether waits and no-shows pay, invoice deadlines and payment timing, and what happens to rates when the plan year turns over on January 1.

Handling plan trips in HealthRide

HealthRide connects with MTM, Alivi and Sentry. When one of them sends you a new trip, it lands on your board by itself, so nobody retypes it or copies it out of a portal (broker connections). Plan rides then share one dispatch board with your Medicaid, facility, and private-pay trips, and a single team schedules the lot.