Medicare Advantage Transportation in 2027: How NEMT Companies Get Plan Ride Trips

Medicare Advantage plans cover about 36 million people, and many of their plans promise rides to the doctor. Original Medicare pays for none of those rides. The plan pays for them, and a broker often books them with transportation companies like yours.

How Medicare Advantage plans cover rides

Original Medicare pays for no car, van, wheelchair van, or stretcher van rides. Its only ride benefit is the ambulance, when any other vehicle could endanger the patient’s health. See does Medicare cover non-emergency transportation for those rules.

Medicare Advantage plans must cover what Original Medicare covers, with a few exceptions such as hospice. They may also add benefits Original Medicare does not cover, called supplemental benefits (42 CFR 422.100(c)). Rides are one of those extras.

CMS’s Medicare Managed Care Manual (chapter 4, section 30.3, revised April 22, 2016) sets the ground rules for a ride benefit:

• It is optional. A plan does not have to provide rides to non-emergency Part A and Part B services, but it may offer them as a supplemental benefit.
• It serves health care. The rides must be used only for the member’s health care needs, such as trips to doctor visits, and never for non-health purposes.
• The plan arranges it. The plan must arrange the rides or provide them itself, and describe the benefit in the plan benefit package it files with CMS.

A second kind of ride benefit goes further. Plans may offer special supplemental benefits for the chronically ill (SSBCI) to members who meet a three-part test: a medically complex chronic condition that is life threatening or significantly limits health or function, a high risk of hospitalization or other bad health outcomes, and a need for intensive care coordination (42 CFR 422.102(f)). CMS guidance of April 24, 2019 lists “transportation for non-medical needs,” such as grocery shopping and banking, as one of those benefits. The plan may reimburse, arrange, or directly provide those rides.

How many Medicare Advantage plans offer rides in 2026

As of September 2026, 35,969,461 people were in Medicare Advantage plans, including 8,453,338 in special needs plans (CMS monthly contract summary). CMS’s 2026 plan benefit package file shows which of their plans include rides.

Counting the 5,557 Medicare Advantage plan options sold to individuals for 2026, with employer-only plans, cost plans, and PACE left out, 2,128 include a supplemental ride benefit. That is 38 percent. Special needs plans are far more likely to have one.

Plan type (2026)	Plans	With a ride benefit	Share
Dual eligible special needs plans (D-SNPs), for people with Medicare and Medicaid	1,085	789	73%
Institutional special needs plans, for people in nursing homes or who need that level of care	156	114	73%
Chronic condition special needs plans	562	315	56%
Plans that are not special needs plans	3,754	910	24%
All plans sold to individuals	5,557	2,128	38%

Rides for non-medical needs are less common. For 2026, 846 of the same 5,557 plans (15 percent) offer transportation for non-medical needs as an SSBCI, and only to members who qualify.

What the 2026 ride benefits look like

The same file shows how each plan built its benefit. These figures cover the 2,128 plans with rides.

Feature	Plans	Share
Rides only to plan-approved health care places	1,991	94%
Rides to any health care place	137	6%
No limit on the number of trips	361	17%
A yearly trip limit	1,765	83%
Authorization required for rides	984	46%
Van listed as a mode	2,000	94%
Rideshare listed as a mode	1,558	73%
Taxi listed as a mode	1,213	57%
Medical transport listed as a mode	811	38%
Bus or subway listed as a mode	487	23%

Among the 1,755 plans that count a yearly limit in one-way trips, the median limit is 24. The most common limits are 24 one-way trips (590 plans), 36 (214), 12 (197), 48 (131), and 60 (101).

Those limits are small next to a standing order. A rider with dialysis three times a week needs 312 one-way trips a year, so a 24-trip benefit covers about four weeks. After that, Medicaid covers the rides for a rider with full Medicaid. Otherwise the rider may have to pay. See dialysis transportation and private pay NEMT.

Who manages Medicare Advantage rides

Many plans hand their rides to a broker, which books each trip with a transportation company in its network. These brokers show Medicare Advantage work on their own pages or on plan pages as of September 2026:

Broker	Medicare Advantage work it shows	Where it shows
MTM Health	Medicare plans from UnitedHealthcare, Humana, Aetna, Elevance, Molina, HealthSpring, and Zing Health, plus Medicaid and D-SNP members of Community Health Choice and El Paso Health in Texas	MTM’s member app page
Alivi	Wellcare’s Florida Medicare members. Its facility booking form also lists CarePlus, Devoted, Gold Kidney, Humana Medicare, and Solis.	Wellcare’s Florida Medicare Quick Reference Guide (January 2026) and Alivi’s provider resources page
Modivcare	Sells NEMT to Medicare Advantage and special needs plans, and gives its transportation providers training for serving Medicaid and Medicare members	Modivcare’s Medicare Advantage and transportation provider pages
Transdev Health Solutions	Medicaid and Medicare rides for AlohaCare members in Hawaii, with a separate Medicare booking line	Transdev’s AlohaCare pages

A plan may use different ride companies in different areas, so confirm the broker for each plan and county.

Plans also switch brokers. HealthSpring moved its Medicare Advantage members’ rides from Modivcare to MTM Health on March 1, 2026, making MTM its sole NEMT provider for those members. HealthSpring said recurring trips and trips already booked for after that date would be handled by MTM. From that day, those trips come only through MTM’s network. See HealthSpring’s move to MTM Health and working with multiple NEMT brokers.

How to find who runs rides for a plan

1. Search Medicare Plan Finder by ZIP code for the counties you serve and note which plans list transportation.
2. Read each plan’s benefit description. Every plan must describe its benefits, with their conditions and limits, to members at enrollment and every year by the start of the annual election period on October 15 (42 CFR 422.111).
3. Check the plan’s provider guide or provider news. Wellcare’s January 2026 Florida Medicare guide names Alivi, 1-855-519-6684, as its transportation vendor. HealthSpring announced its change to MTM Health on its provider news page.
4. Ask the clinics and dialysis centers you serve which company books their Medicare Advantage patients.

How to join a Medicare Advantage ride network

You do not sign with CMS or, in most cases, with the plan. You sign with the broker, which signs with the plan.

1. Map the plans and brokers in your service area using the steps above.
2. Ask each broker’s provider team whether it needs capacity for Medicare Advantage members in your counties, which plans, and which vehicle types.
3. Apply. MTM Health takes applications on its service providers page, Modivcare on its transportation provider page, and Alivi through its provider form. See how to get NEMT broker contracts.
4. Pass credentialing. Expect the business, insurance, vehicle, and driver files a Medicaid broker asks for. See NEMT broker credentialing and the credentialing checklist.
5. Sign the Medicare paperwork. Plan work adds compliance attestations, covered in the next section.
6. Set up monthly exclusion checks and long record keeping before your first trip.
7. Learn each plan’s booking rules. Alivi’s Wellcare page says members book 72 hours (3 business days) ahead and up to 30 days out, and a will-call pickup must happen within 60 minutes of the member’s call.
8. Ask how trips count against the member’s limit and what the broker does when a member runs out, so your dispatcher never books a ride nobody will pay for.

The Medicare rules that come with plan trips

In Medicare’s terms, the broker is the plan’s first tier entity and your company is a downstream entity (42 CFR 422.2). The plan stays responsible for everything in its CMS contract, so it must push these rules down to you in writing (42 CFR 422.504(i)):

Rule	Where it comes from	What it means for your company
Records open to audit for 10 years	42 CFR 422.504(i)(2)	HHS, the Comptroller General, or their designees may inspect your books, contracts, systems, and trip records directly, through 10 years after the contract period ends or an audit closes, whichever is later
No billing members for covered rides	42 CFR 422.504(g) and (i)(3)	Your contract must bar you from holding a member liable for fees the plan owes
Exclusion checks before contracting and monthly	Medicare Managed Care Manual, chapter 21 (Rev. 110, January 11, 2013), section 50.6.8	Plans must check downstream entities against the OIG exclusion list and the GSA exclusion list, now kept in SAM, before contracting and monthly after that
No excluded or precluded payees	42 CFR 422.752(a)(8) and 422.504(i)(2)(v)	A plan faces sanctions for contracting with anyone excluded from Medicare, and your contract must say you will make sure no payment goes to anyone on CMS’s preclusion list
Follow Medicare rules	42 CFR 422.504(i)(4)(v)	Every downstream contract must say you comply with Medicare laws, regulations, and CMS instructions
Ongoing monitoring	42 CFR 422.503(b)(4)(vi) and 422.504(i)(4)	The plan must monitor performance and can revoke delegated work, so expect audits

Brokers turn these rules into forms. Alivi’s Downstream Provider Oversight Policy, effective January 1, 2025, requires every downstream provider to sign a compliance attestation before starting and every year after. It covers the code of conduct, general compliance and fraud, waste, and abuse training, OIG and SAM screenings, HIPAA, record retention, background screening, and ownership disclosure. Alivi audits at least 5 percent of active downstream providers each year and requires a corrective action plan for any gap. Its record retention policy keeps trip logs, driver logs, and vehicle records for at least 10 years.

Even Medicaid networks ask for this. Transdev’s Oregon provider FAQ of January 19, 2024 has providers sign a Medicare Advantage program form because some riders have both Medicaid and Medicare.

To be ready:

• Screen every owner, driver, and office worker against the OIG exclusion list and SAM exclusions before hire and every month. The exclusion screening log keeps the proof.
• Keep trip records for at least 10 years. See NEMT record retention.
• Train staff once a year on compliance and fraud, waste, and abuse, and keep sign-in sheets. See NEMT compliance program.

Dual eligible riders: plan rides or Medicaid rides

Many Medicare Advantage riders also have Medicaid. When a dual eligible rider with full Medicaid goes to a Medicaid-coverable service, the state must still ensure the ride, even when Medicare pays first for the care (CMS Medicaid Transportation Coverage Guide, SMD 23-006, September 28, 2023). The plan may offer rides too. Special needs plans for these riders are called dual special needs plans.

CMS’s January 14, 2025 FAQs on dual eligible billing set the order:

• Medicaid pays last. Medicaid is generally the payer of last resort for these riders.
• The plan may come first. A state may require an out-of-network provider to bill the Medicare Advantage plan first when the plan covers the supplemental service out of network.
• No Medicare enrollment needed for plan extras. Plans generally do not require out-of-network providers to enroll in Medicare for supplemental services.

When a plan uses a broker, you bill the broker for the plan’s rides. One broker can hold both sides. MTM Health lists Community Health Choice and El Paso Health in Texas for both Medicaid and D-SNP members, so one network contract can reach the same rider under both programs. See third party liability for how states chase the right payer.

What Medicare Advantage trips pay

Brokers set Medicare Advantage rates in each provider’s agreement. Ask for the rate sheet by mode before you sign, and compare it with your state’s Medicaid fee schedule and your own cost per trip.

Ask these questions for each plan:

• What is the base rate and mileage rate for ambulatory, wheelchair, and stretcher trips?
• Are no-shows, wait time, or extra riders paid?
• How long do you have to submit a trip, and how fast does the broker pay?
• Does the rate change when the plan’s contract renews on January 1?

See how to negotiate NEMT broker rates and how to bill NEMT brokers.

The yearly calendar and what changes for 2027

Plan benefits follow a fixed federal calendar:

When	What happens
First Monday in June (June 1, 2026)	Plans submit bids for next year, with their benefits (42 CFR 422.254)
October 1	Plans may start marketing next year’s plans (42 CFR 422.2263)
By October 15	Members must have a description of the plan’s benefits and limits
October 15 to December 7	Members can join, switch, or drop plans (42 CFR 422.62)
January 1	New benefits, trip limits, and plan contracts take effect

CMS’s final rule of April 6, 2026 (91 FR 17384) applies to coverage beginning January 1, 2027. Three parts touch plan rides:

• Eligibility rules go public. For each SSBCI, including rides for non-medical needs, a plan must list its written eligibility policies and objective criteria on its public website. CMS says a member’s own statement that they qualify is not enough.
• Debit card benefits get a backup. Plans that pay for benefits by debit card must also have a way to reimburse members when the card cannot be used at the point of sale.
• No mid-year reminder letter. The rule drops a planned notice listing each member’s unused supplemental benefits. CMS had already delayed enforcement on September 8, 2025.

The practical step is the same every year. In October and November, ask each broker which plans it will manage in your counties for 2027, what the new trip limits are, and whether rates change on January 1.