If these options do not work for you, you might need to explore the more costly option of private transportation. The most basic form of private transportation is a taxi service. This option is most appropriate if you require occasional travel and a minimal amount of extra assistance, but cannot access public transportation. It's also a good option if you live in a rural area without extensive public transportation, need to travel late at night or during rush hours, or if you simply do not feel secure when traveling. The cost of a single ride in a taxi varies greatly depending on the location and the distance traveled, but it's safe to assume that the minimum one-way fare will be $5.00 and could be as high as $20.00 to $40.00, including tips and tolls.
A likely scenario that might require a senior to seek private services would involve medical necessity. Many private companies supply vehicles know as "cabulances" or coaches. A cabulance or a coach is appropriate for a senior who can't spend time on public transportation and requires constant assistance during a trip. A senior on kidney dialysis or suffering from Alzheimer's or Parkinson's disease might be an appropriate passenger for this service. A cabulance has wheelchair accessibility and provides door-to-door service with assistance from the driver who will help the passenger out of his/her house and into the cabulance. Some cabulances provide stretcher service for people unable to sit upright. Although Medicaid will cover cabulance rides taken specifically to access medical services, the cost for a non-medical trip can run from $20 to $100 or more roundtrip. As mentioned previously, Medicare usually only covers emergency transportation rides, but if the patient has a particularly chronic case, Medicare might cover a non-emergency medical trip in a cabulance. In addition, unlike public services, cabulance services must be scheduled far in advance — sometimes up to two weeks. Also, the senior must be prepared to wait for the vehicle to arrive. Unlike public services, the government does not regulate cabulance organizations and the company is free to give a three to six hour spread in possible pick-up time.
In the most extreme cases of medical necessity, you may want to employ a private ambulance for transportation. Many of the same companies that operate cabulances also lease ambulances. Most often, private ambulances contract with nursing homes and hospitals to provide transportation for their clientele. Ambulances are used in cases in which a person is bedridden. Usually this implies a high degree of physical impairment, but it can include temporarily disabling injuries such as a broken hip. Two types of ambulance services exist depending on the needs of the patient. The first comes equipped with basic life support devices. The attendant monitors the person's vital signs throughout the trip, including blood pressure checks. The second type of ambulance service is more advanced and will have a trained staff member on the trip who can start an IV (intravenous transfusion) or administer oxygen to the patient, if necessary.