This is general information, not insurance, medical, legal or financial advice. Benefits, tax rules and assistance programs differ by country, plan and employer, so confirm details with your insurer or plan administrator.
Sometimes the right treatment is not nearby. A specialist, a surgical team or a clinical program may be hours away, and the trip itself can add a real cost: fuel or tickets, lodging, meals, and sometimes time off work for you and a companion. Many people are surprised to learn that health plans often pay for the treatment but not the journey.
What plans typically do and do not cover
As a general pattern, and with plenty of variation:
- Emergency ambulance transport: often covered at least in part, particularly in a true emergency, though the plan may question whether the transport was necessary
- Non-emergency medical transport: sometimes covered when a clinician certifies that you cannot travel any other way, and sometimes requires approval first
- Everyday travel to appointments: fuel, parking, bus or train fares, and flights are commonly not covered
- Lodging and meals: commonly excluded
- Companion costs: commonly excluded, though a few plans or programs make exceptions for a parent traveling with a child
- Air ambulance: a very specialized and expensive service. Coverage, limits and network rules vary, so understanding your plan in advance is helpful
Some plans or employers provide a travel or lodging benefit for particular situations, such as treatment at a designated center, or care that is not available within a reasonable distance. If your plan sends you to a specific facility, ask whether any travel allowance goes with that referral. These are exceptions rather than the norm.
Questions to ask your plan
Before you commit to a trip, call member services and ask:
- Is the treatment itself covered at that facility, and is the facility in my network?
- Does the plan cover any transport, lodging or meals for it?
- Do I need prior authorization for the treatment, and for any transport?
- If I travel out of network, what changes in my costs?
- Is there a care coordinator or case manager who can help me?
A case manager, where offered, may know about benefits that are not obvious from the policy booklet. Ask for answers in writing when the cost is significant, and note who you spoke with and when.
Check the treatment is covered at the destination
The travel cost is only part of the picture. If the facility is outside your network, the treatment may cost more or may not be covered, which can far outweigh the price of the trip. This is worth confirming before you arrange travel. Surprise charges from out-of-network providers can be an issue, and your plan’s rules on out-of-network care and any protections available where you live are worth understanding first.
Tax treatment and health accounts
In some places, certain medical travel costs may be treated as a deductible medical expense or may be eligible for payment from a tax-advantaged account. Whether that is true, and which costs count, depends on local rules, and those rules are precise and change. Do not rely on a general article, including this one. Ask your plan administrator or a qualified tax professional, and keep records in case you are asked to justify an expense. If you use a health savings account or flexible spending account, check whether travel counts as an eligible expense under your plan’s rules before spending from it.
Other sources of help
If your insurance does not pay for travel, other sources sometimes exist. Availability depends on where you live, and none is guaranteed:
- The hospital’s social worker or patient navigator, who often knows about local assistance
- Hospital financial assistance programs, which may sometimes extend beyond the bill itself
- Charities and nonprofit organizations tied to particular conditions
- Volunteer driving or flight programs for patients
- Lodging near hospitals offered at reduced cost for patients and families
- Public programs, which in some systems include non-emergency transport for eligible people
- Employer benefits, such as an employee assistance program or a leave policy
Ask the treatment center early. Staff frequently know which programs are active and what the eligibility rules are.
Keep records
Whether for a claim, an account reimbursement, a charity application or a tax deduction, records help. Keep:
- Receipts for tickets, lodging and meals
- A mileage log with dates and destinations if you drive
- Letters from your clinician explaining why the travel was necessary
- Appointment confirmations showing dates
- Any insurer correspondence about transport approval
If a transport claim is denied
Read the reason in the denial letter. A common issue is that the insurer decided a different, less costly mode of transport would have been appropriate, or that the transport was not medically necessary. A supporting letter from your clinician and the usual appeal process may help, though results are not assured.
Planning the whole cost, including the trip, before treatment begins is usually the best way to avoid financial shock.