Introduction: Nonemergency medical transportation (NEMT) is a supplemental benefit in Medicare Advantage (MA) plans that helps individuals overcome transportation barriers to healthcare services. It remains unclear whether these benefits are targeted to communities with greater needs.
Methods: We analyzed MA plan benefit data from 2020 to 2024 across 2764 US counties. Transportation barriers were assessed using 5 indicators: vehicle ownership, income levels, self-reported health status, avoidable hospital visits, and access to primary care. We examined trends in NEMT availability and its alignment with county-level transportation need, considering MA plan penetration as a modifying factor.
Results: Nonemergency medical transportation benefit prevalence in MA plans increased by 13.88% points from 2020 to 2024. In 2024, counties with the greatest transportation barriers had a 19.4% point higher prevalence of NEMT offerings compared to counties with the fewest barriers. Alignment was stronger in counties with higher MA plan penetration.
Conclusion: Medicare Advantage plans increasingly offer NEMT benefits in areas with greater transportation challenges, especially where MA plan penetration is higher. These findings suggest responsiveness to social needs and the potential role of market dynamics. Policymakers can support equitable access by incorporating transportation needs into MA plan evaluations.
Keywords: MA penetration; Medicare Advantage (MA); access to care; health equity; healthcare access; healthcare disparities; nonemergency medical transportation (NEMT); policy implication; social determinants of health; social needs; supplemental benefits; transportation barriers to care; transportation challenges.
© The Author(s) 2025. Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc.