What to Know About Transportation Services for Older People

Medically Reviewed by Mahammad Juber, MD on June 29, 2022
4 min read

Almost 90% of older people choose to remain in their homes and communities, and around 600,000 older adults stop driving every year. When older people stop driving, access to reliable transportation services becomes essential to their ability to maintain their independence.

Unfortunately, a lack of safe, accessible, reliable senior transportation is a barrier to completing instrumental activities of daily living (IADLs) such as shopping, attending healthcare appointments, and attending social functions. Older people without reliable transport services are at risk for social isolation, which has similar health risks to obesity and smoking. 

If you or your loved one is looking for safe and reliable senior transport services, read on to learn what you need to know about transportation services for older people. 

While physical and mental changes associated with aging can prevent people from driving safely, there's no set age when an elderly person needs to stop driving. Many older people are safe drivers, and around 80% of people age 65 and older still hold driver's licenses.

As age increases, though, so does the risk of motor vehicle fatalities. Fatal car crash numbers spike after age 70 and are highest in drivers age 85 and older. This is due to an increased risk of car crashes and medical complications after a car accident.

Warning signs that you or a senior loved one may need to stop driving include: 

  • Failure to yield or stop when legally required
  • Confusion about the right of way
  • Confusion about or inability to keep track of speed limits
  • Consistently forgetting to signal when turning or changing lanes
  • Routinely becoming lost, especially in familiar areas
  • Erratic control of a vehicle's speed
  • Inability to recognize the distance between the car and objects
  • Rage, anxiety, or stress associated with driving
  • Frequent "near misses" where accidents almost occur 
  • Frequent traffic violations

If you or a loved one is exhibiting these signs, it may be time to look into transportation options for elderly adults.

Public transportation such as community buses and light rail services are a good option for many independent older people in good health. Public transportation services provide fixed-route services, so older people will need to be able to access a bus stop or train station. 

Fortunately, public transportation has many benefits, including:

  • Low cost
  • Reliable schedules
  • No reservations required

Many public transportation services offer discounted fares for older people, and vouchers for free rides may be available.


Per the Americans with Disabilities Act, public transportation services must offer paratransit for individuals unable to use a fixed route. Paratransit services must operate within 3/4 of a mile of a fixed route service and be available during the same hours.

To qualify for paratransit services, you typically first need to apply. Medical documentation supporting your inability to access a fixed route may be required.

Paratransit can cost more than fixed-route public transportation but cannot be more than twice the regular fare.

Public Transportation Limitations for Older People

Around 25% of older people aged 65 and older live in rural communities. This percentage is expected to increase as baby boomers continue to age and younger adults move into urban areas. Many rural areas lack reliable public transportation services, though, and older people in rural areas are likely to be farther from essential services such as medical care and grocery stores.

Demand-response transportation, also known as dial-a-ride, is a transportation service that operates by passenger request. Demand-response transportation services are typically curb-to-curb, eliminating the need for older people to access a fixed service point or navigate a public transportation route.

However, these services can be expensive, ranging from $40 to $150 an hour. One-third of adults aged 65 or over are financially insecure, so these services may not be an option for many older people.

Taxi companies and ridesharing companies (such as Uber and Lyft) offer curb-to-curb rides to individuals for a fare, which can be a set rate or a fee per mile/minute.

While these services are convenient, they can be expensive. Additionally, some older people have difficulty navigating ride-sharing services, which often rely on app-based or internet-based scheduling. Some community agencies offer vouchers or scheduling assistance, though, to help older adults who need curb-to-curb transportation access taxi or ridesharing services.

Many local faith-based organizations and community volunteer organizations, such as the National Volunteer Transportation Center, offer volunteer transportation services. These services may include volunteer drivers, shared vehicles, and ridesharing assistance. 

Volunteer transportation services are typically door-to-door. Many volunteer services are free, though some charge a nominal fee to help cover their costs.

Many older people and their families worry about access to routine medical care when they or their loved one stops driving. Some options specifically for driving the elderly to appointments include: 

Medicaid Non-Emergency Medical Transportation (NEMT)

Medicaid non-emergency medical transportation (NEMT) provides reliable transportation to and from Medicaid-approved appointments for eligible Medicaid beneficiaries. Requirements for NEMT vary by state. Suppose you're in a Medicare-managed care plan. In that case, your care plan's customer service line will typically have information about medical transportation services.

Medicare Transportation Services

Unlike Medicaid, Medicare does not routinely provide transportation services for non-emergency medical appointments, though Medicare part B covers some non-emergency transportation if it's deemed medically necessary.

Some Medicare Advantage plans offer transportation services for health care appointments, but this varies by plan. Contact your Medicare Advantage plan's customer service line for details on transportation benefits.