Page Reviewed / Updated - Nov. 2017
Affordable public and private transportation options exist for seniors who are unable to drive, but finding, understanding, and utilizing these services is not as straight-forward as one would hope, and unfortunately, the process can be time-consuming and frustrating. It often works best when an adult child, social worker, or other loved one takes on the responsibility of researching services, registering the senior, and teaching him or her the processes involved in scheduling and using the transportation service. Bear in mind, there are many aspects to consider, such as eligibility criteria, pick-up locations, hours of operation, routes, wheelchair accessibility access, and the purpose of the trip. It is advisable that the elderly rider have a smartphone and be comfortable with its operation, not just for communication, but also for ride coordination and to allow a loved one to track the rider’s location should a trip not go as planned.
The cost of transportation options for elderly persons who can no longer drive themselves ranges significantly. Public Para-Transit Services (special transportation services intended for individuals who are elderly or disabled) cost approximately twice as much as public transportation does for the same route. For example, if a city charges two dollars for bus fare, the Para-Transit Service is legally only permitted to charge four dollars. Some Volunteer Driver programs may charge five to ten dollars per ride, while others may provide rides free of charge. Private services are considerably more expensive, costing as much as twenty to forty dollars per trip.
Does Medicare pay for transportation services for seniors? This is a common question around which there is considerable confusion. Unfortunately, the short answer is, no, Medicare will not pay. The confusion stems from the fact that Medicare will pay for emergency medically needed transportation services, such as an ambulance. However, Medicare, even if the rider is going to a medical appointment, will not cover non-medical or non-emergency transportation.
Medicaid, on the other hand, does offer several forms of transportation assistance for seniors or disabled persons. Before further explanation, it is important to remember that Medicaid is not a single program, but rather a collection of different programs. Furthermore, the benefits of these programs differ in every state. Some Medicaid programs, through Home and Community Based Services (HCBS) Waivers, will provide funding for transportation, usually, but not always, with the stipulation that the purpose of the ride is for a medical appointment with a doctor or physical therapist. Another way Medicaid provides assistance is by paying for a Personal Care Attendant (PCA), who will be able to accompany the elderly or disabled individual on Para-Transit Services. Regular Medicaid will also cover non-emergency, medical transportation. See a list of Medicaid programs by state or read more about Medicaid eligibility.
The eligibility requirements for assisted transportation depend almost entirely on the type of assisted transportation service, which is discussed in greater depth below under Types of Programs. Briefly, one eligibility requirement is based on one’s level of disability. However, it is possible for one’s disability to be too great for some forms of transportation assistance or for one’s disability to be too minimal for others. To clarify, some private ride services might not be able to accommodate an individual who is wheelchair-bound, while other services may require a formal designation of “disabled” by the Social Security Administration (SSA) to qualify. Therefore, elderly persons who are feeble simply as a result of aging may not qualify.
The purpose of travel is another factor used by services to determine if one is eligible for assistance. Some programs only offer rides for non-emergency, medical appointments, and other services place no such requirements on the rider, enabling the individual to use the service for shopping, errands, or simply for social visits.
Age is almost never a factor in determining eligibility. Surprisingly, very few ride services use financial criteria as a qualifying factor for eligibility.
With the exception of a few private ride services, nearly all transportation options require a rider to have pre-registered with the service prior to scheduling a ride.
As implied by the name, these are programs in which volunteers assist seniors and disabled persons by providing door-to-door transportation. These are regional, independent programs; therefore, it is difficult to generalize about the specific details. Also worth noting is that not all areas of the country offer these programs. Typically, volunteer drivers use their own vehicles and are unable to transport motorized wheelchairs. However, because there is usually only a single passenger, drivers are able to help their riders from their homes and through the doors at their destinations. Riders must register with the program in advance of scheduling a ride. Once signed up with the program as a rider, specific rides will need to be scheduled, typically a day or two in advance. Usually, these programs do not limit the reasons for which passengers can request a ride. For example, rides can be for social outings or medical appointments. However, emergency medical transportation is not an option. The cost of Volunteer Driver programs is free or very inexpensive (five to ten dollars per ride, so inexpensive when compared to private transportation services).
Find a Volunteer Driver Program near you. This map will show the names of programs in your state. Users must contact the specific program to learn the details. Be warned that the process is not always straight-forward and easy.
Often called Door-Through-Door services, Door-to-Door or abbreviated D2D, these are private companies that charge riders for their assistance. These services are not unlike taxis, but are specifically designed for elderly and disabled persons. Therefore, assistance is provided getting from one’s residence to the vehicle, getting in and out of the vehicle, and getting from the vehicle through the door at the rider’s destination. Assistance can also be provided carrying bags, loading wheelchairs, and carrying purchases made during the outing. Some vehicles are equipped to transport a motorized wheelchair (at an additional change), and some vehicles are even designed for persons with higher medical needs, these are referred to as “cabulances” (cab + ambulance). Private ride service companies offer greater flexibility, often allowing for same day or on-demand scheduling, but this flexibility comes at an additional cost. One can expect charges of twenty to forty dollars per ride.
Private ride services for seniors tend to be limited to urban and suburban areas. SilverRide and Gogograndparent are two of the more widely known private ride transportation services.
The Americans With Disabilities Act (ADA) states that any city that provides public transportation must also provide a system that accommodates for persons with disabilities covering, more or less, the same geographic area. These secondary systems are referred to as Para-Transit Services, and they typically utilize wheelchair-accessible vans instead of buses. It is important to note that drivers are not able to assist riders from their houses; the service is “curb-to-curb”. This means riders must be able to get from their homes to the curb for pick-up and from drop-off to their destinations. It is common for non-disabled persons to accompany the disabled person on Para-Transit to assist in getting from their homes to the “bus-stop”. However, drivers can assist riders in getting in and out of the vehicle. Transportation escorts are often called Personal Care Attendants (PCA), and Medicaid may pay for their assistance.
There are other pros and cons to Para-Transit services. On the plus side, they are inexpensive. By law, they can charge only twice what the public transportation system charges for the same route. For example, if a cross-town subway ride costs $3, the Para-Transit service can charge a maximum of $6. Riders must register with the system in advance and be determined eligible, so paperwork and wait-time is a reality. Not all seniors will qualify, but most elderly persons who are unable to drive a vehicle will qualify. Eligibility is based more on the candidate’s inability to use public transit, than a formal designation of “disabled” by the Social Security Administration.
Rides must be scheduled in advance and is typically a minimum of 24-hrs. Pick-up times are scheduled, but Para-Transit Services are given flexibility to be early or late. Therefore, it is not unheard of for riders to have to wait 30 minutes. In cold weather, this is a considerable obstacle.
On the whole, Para-Transit Services are a good option for a certain segment of seniors. However, the logistics can be challenging, and an elderly individual may require the assistance of an adult child or other loved one to overcome the initial obstacles.
Detailed information about Para-Transit rules are available here. Finding Para-Transit Services in Your Area. Unfortunately, there is not a single, nationwide database of Para-Transit Services. However, one’s local Area Agency on Aging (AAA) will be able to assist callers in finding their local Para-Transit Service. Find your local Area Agency on Aging here.