I cannot drive right now: how can I keep my independence?
A practical plan for rides, costs and schedules while you are not driving
Maybe your doctor told you not to drive yet. Maybe your license is on hold, or you know your focus is not where it needs to be. Either way, giving up the car can make it feel like someone else is running your day.
A brain injury can affect many of the skills driving needs, including reaction time, attention, judgment and memory [1]. Stepping back from the wheel while you heal is a safety choice, and you can still plan how to get where you need to go.
This guide covers the nuts and bolts of getting around. You will find ride options and costs, paratransit steps, ride planning for a forgetful day and the road back to driving. For keeping friendships and social plans going, see our guide to staying connected when you cannot drive.
Start with a map of your trips
Before you call anyone, write down where you go in a normal two weeks. Include medical visits, therapy, the pharmacy, groceries, work or school, worship and time with friends. A planning guide from the Eldercare Locator suggests listing each place you go and then the ways you could get there [2].
Next to each trip, note three things:
- How often it happens: twice a week, once a month or now and then.
- How much help you need: a ride only, help to the door, or someone to come inside with you.
- How fixed the time is: a set therapy slot, or a store run you can move.
Fixed, frequent trips fit a booked service like paratransit or a standing family ride. Flexible trips can wait for a cheaper option or a friend’s free afternoon.
Then look for trips you can cut. Many pharmacies and grocery stores deliver. The CDC suggests asking your doctor about video or phone visits when getting to the office is hard [3]. Booking two visits on the same day saves a whole round trip.
You do not have to sort this out alone. Social workers can help you find and coordinate rides and other community services [4]. Ask for the social worker at your hospital, rehab program or clinic. If you are an older adult, the Eldercare Locator at 1-800-677-1116 can connect you with your local Area Agency on Aging [5]. Ask there for a mobility counselor, who knows the ride options near you [2].
Your ride options at a glance
Most areas have several kinds of rides, and a mix often works best. You might use a booked service for therapy, a family member for weekend errands and a paid ride as a backup.
Comparison compiled by Safety Behind the Wheel Foundation
Ride options compared
| Option | Best for | Typical cost to you | How to book |
|---|---|---|---|
| Bus or train with a reduced fare | People who can ride alone once they learn the route | Off peak fare capped at half the peak fare on systems that get federal money | Ask your transit agency for a reduced fare card |
| ADA paratransit | People whose disability keeps them off the bus or train for some or all trips | Up to twice the regular fare | Apply first, then book up to the day before |
| Medicaid medical rides | Medicaid members with no other way to reach medical care | Set by your state; some add small copays or trip limits | Call your state Medicaid ride line, ride broker or health plan |
| Medicare Advantage ride benefit | Members of plans that include rides | Set by the plan | Call the number on your plan card |
| Volunteer driver program | Medical visits, errands and outings, often with help at the door | Varies, so ask each program | Call days ahead if you can |
| Community dial a ride or senior van | Local trips for older adults or people with disabilities | Varies by program | Call your transit agency or aging office |
| Taxi or rideshare | Last minute or occasional trips | Highest per trip; a rural round trip to the doctor can reach $100 | App or phone, on demand |
| Family and friends schedule | Regular trips with people you trust | Free, or gas money | A shared calendar with set days |
Medicaid rides. Federal rules require state Medicaid programs to provide rides to medical care [10]. The benefit is for members with no other way to get there, and it only covers trips to medical services [9]. Rides may come by van, taxi, wheelchair van or public transit [9, 10]. In some states, Medicaid can even pay for trips in a family member’s or friend’s own car [10]. The rules differ by state, so ask your state Medicaid office what is covered where you live [10].
Medicare rides. Some Medicare Advantage plans add rides to medical visits, but that extra is shrinking. KFF found that 24% of individual plans offered it in 2026, down from 30% in 2025 [12]. Check your plan’s current benefits, since extras can change from year to year.
Volunteer drivers. These programs use trained volunteers to take riders to medical visits, stores and social outings, often helping them to the door [13]. They can go where a bus does not, such as across county lines or to several stops in one trip [13]. Volunteer time is limited, so book early and keep a backup.
How to apply for ADA paratransit
The Americans with Disabilities Act requires transit systems with regular bus or rail routes to offer paratransit [7]. Paratransit is a shared van or car that takes you from where you are to where you need to go. If you qualify, the service is your civil right [7].
The agency decides based on whether your disability keeps you from using the regular bus, and a diagnosis alone does not settle it [8]. With memory problems, you might get lost between stops or lose track of a transfer. A temporary disability can count, and some people qualify for certain trips only [7].
- Call your local transit agency and ask for the ADA paratransit application. Each agency sets its own process. It may include a form, a note from your provider, an interview or an in person check of how you handle the bus [7].
- Ask your care team for help with the form. An occupational therapist, speech language pathologist or doctor can describe what happens when you try to ride alone. Bring a family member to any interview to fill in details you may not remember.
- Watch the calendar. If the agency has not decided within 21 days after getting your complete application, it must give you rides until it decides [14]. The decision has to be in writing, with reasons if you are turned down [14].
- Appeal if you are denied. Agencies must offer an appeal, and some require you to file within 60 days [14].
- Note the end date. Approval comes with an expiration date, and the agency may ask you to show again that you qualify [14]. Put that date in your calendar now.
Once you are approved, a few rules help you plan. The service covers trips within three quarters of a mile of a regular route, during the same hours the buses run [7]. You can book any time the day before [7]. The agency may offer a pickup time up to an hour before or after the time you asked for [8]. If you need help getting from the door to the van, ask, because agencies must give extra help case by case [8].
A personal care attendant rides free. One friend or family member can ride with you at the same fare if there is room [7]. When you travel, proof that you qualify at home usually lets you use another city’s service for up to 21 days a year [8].
What rides cost, and how to spend less
The same trip can cost nothing or a lot. These habits keep the bill down:
- Ask for reduced fares. At off peak times, transit systems that get federal money cannot charge older adults, people with disabilities or Medicare card holders more than half the peak fare [6].
- Know the paratransit cap. The fare can be no more than twice the full fare for a similar bus trip [8]. Your attendant pays nothing [7].
- Use Medicaid rides for medical trips. Some states limit the number of trips, need approval first or charge a small copay, so ask about the rules [10].
- Check your Medicare Advantage plan. Only some plans include rides, so look at your current benefits [12].
- Save paid rides for gaps. Taxi and rideshare fares add up fast, especially in rural areas [13].
- Keep family rides fair. Offering gas money, or trading favors like a home cooked meal, keeps rides from feeling one sided.
Plan rides around your memory
Booked rides depend on you being ready on time, which is hard when memory slips. Paratransit agencies may suspend riders who show a pattern of missed trips [14]. Misses caused by things outside your control, such as a late van, cannot count against you [14]. You must get written notice and a chance to explain before any suspension [8, 14]. A late cancellation can count the same as a no show, so cancel as early as you can [8].
These setups make a missed ride less likely:
- Use one calendar. Put each ride in the same planner or phone calendar as your appointments. Write the pickup window, the ride service’s phone number and your trip confirmation number.
- Set two alarms. Set one for the night before and one for 30 minutes before the pickup window opens.
- Book both ways at once. Schedule the ride home when you book the ride there, and write both on the same line.
- Wait in the same spot. Sit by the same window or door each time so you see the van pull up.
- Carry a ride card. Keep a wallet card with your home address, the ride service’s number and an emergency contact, in case you get mixed up away from home.
- Add a helper. Ask a family member to get the text reminders too, or to call you when the window opens.
Plan rides for your best time of day, since shared rides and waiting can drain your energy. If afternoons are your foggy time, our guide on why memory seems worse when you are tired can help you plan around it.
Checklist from Safety Behind the Wheel Foundation
Ride day checklist
- Check today’s rides in your calendar after breakfast
- Pack your ID, insurance card, fare card, phone and charger
- Put the ride card and appointment papers in one pocket or bag
- Bring any medicine you need during the day, plus water and a snack
- Be at your waiting spot when the pickup window opens
- Confirm the ride home before you leave the appointment
- Jot down what you learned at the visit before you head home
Build a family ride schedule that lasts
Family and friends are often the first ride people turn to, but they can wear out if one person handles every trip. A schedule spreads the load, so you ask less often.
- Choose one person to keep the schedule. That person does not have to do all the driving.
- Use one shared calendar, or a paper sign up sheet on the fridge. List each regular trip with the day, time, place and driver.
- Give each helper a set slot, like Tuesday therapy, so they can plan around it.
- Name a backup driver for every week.
- Ask for something specific. “Can you take me to the dentist on the 12th at 2?” is easier to say yes to than “Can you help sometime?”
- If the driver comes inside, ask them to listen and take notes. A second set of ears helps when you may forget what you heard.
Our guide to asking for help and staying connected after a crash covers the harder part: asking without feeling like a burden.
Learning to ride the bus again
Some people can go back to the regular bus or train with practice. Travel training programs teach older adults and people with disabilities how to use public transit on their own [2]. Ask your transit agency whether it offers one. A family member or friend can ride along on your first trips [2].
These habits make practice easier on your memory:
- Learn one route at a time, at the same time of day.
- Make a step card with the stop, the bus number, how many stops to ride and where to get off. Add a photo of each stop.
- Set a phone alarm for one stop before yours.
- Practice when you are rested, and stay away from rush hour at first.
- Keep paratransit as a backup for trips you have not practiced.
Your road back to driving
Research suggests that 60% to 70% of people return to driving after a traumatic brain injury [1]. Many of them change their habits, such as driving less, driving only in daylight or sticking to roads they know [1]. Yet many people go back to driving without having their skills checked first [1].
Knowing a route by heart does not show you are ready, because driving uses attention, reaction time, judgment, vision and problem solving all at once [1]. Ask your doctor when a comprehensive driving evaluation would make sense. It usually has two parts [1]:
- A clinic part, where a doctor, neuropsychologist or occupational therapist checks things like vision, reaction time, attention, judgment and how you judge space.
- A road part, in traffic or in a driving simulator, where an evaluator grades how safely you drive and whether you follow the rules.
A certified driver rehabilitation specialist can do the full evaluation and suggest training or vehicle equipment. You can find one through ADED, the Association for Driver Rehabilitation Specialists, at aded.net [1]. Ask about the cost up front. State vocational rehabilitation agencies may help pay for evaluations and vehicle changes [1].
Your state’s licensing rules matter too. Our guides on returning to driving after brain injury and medical conditions and driving cover readiness and reporting rules in more detail.
Get help right away
A headache that keeps getting worse needs emergency care, and so do weakness or numbness, repeated vomiting, slurred speech, new confusion or extreme drowsiness. If you notice any of these, call 911 [15]. Keep our concussion and TBI red flag checklist where your family can find it.
Questions to ask your care team and ride providers
Question checklist from Safety Behind the Wheel Foundation
- When should I have a comprehensive driving evaluation, and who do you recommend?
- Can you write a letter for my paratransit application that describes how my memory and thinking affect riding the bus alone?
- Can any of my follow up visits happen by video or phone?
- Can my appointments be grouped on one day, at the time of day I am most alert?
- (For Medicaid or your health plan) Do you cover rides to my appointments? How far ahead do I book, and can a helper come?
- (For the transit agency) How long is the pickup window, and what are your rules for cancellations and no shows?
- Is there a travel training program or a volunteer driver program near me?
- Can a social worker help me fill out ride applications?
Frequently asked questions
Can I get paratransit if my disability is a memory problem?
You can, if memory or thinking problems keep you from using the regular bus or train on your own for some or all trips [7, 8]. The agency wants to know what happens when you try to ride, so give real examples, like getting lost or missing your stop.
Does Medicare pay for rides to doctor appointments?
Original Medicare mostly covers ambulance rides when other travel could put your health at risk [11]. Some Medicare Advantage plans add rides to medical visits, though fewer offered them in 2026 than in 2025 [12]. If you have both Medicare and Medicaid, the Medicaid ride benefit may cover trips to medical care [10].
What is the difference between paratransit and Medicaid rides?
Paratransit is a transit service for people whose disability keeps them off the regular bus or train [7]. Medicaid rides are a health benefit that takes members to medical care when they have no other way to get there [9]. You may qualify for both and use each for different trips.
How long before I can drive again after a brain injury?
There is no set timeline. It depends on how your thinking, vision and reaction time recover, and on your state’s rules. Ask your doctor about a comprehensive driving evaluation, which tests the skills driving needs [1].
The bottom line
Recommendation from Safety Behind the Wheel Foundation
List your trips and match each one to the ride that fits it. Apply early for anything that needs approval, like paratransit or Medicaid rides. Put every ride in one calendar with two reminders, and spread family rides across several people. Keep asking your care team when a driving evaluation makes sense.
Related articles
Sources and further reading
- 1Novack T, Marwitz J, Hollis S, Rapport L, Klebine P. “Driving After Traumatic Brain Injury.” Model Systems Knowledge Translation Center, 2024. msktc.org/…/driving-after-traumatic-brai…
- 2Eldercare Locator and National Aging and Disability Transportation Center. “Before You Give Up the Keys: Create a Roadmap for Transportation Independence.” NADTC, undated (accessed 2026). nadtc.org/…/GivingUpTheKeys_Final_508_Ac…
- 3Centers for Disease Control and Prevention. “Where to Get Help.” CDC, 2025. cdc.gov/…/get-help.html
- 4Health in Aging Foundation, American Geriatrics Society. “Tip Sheet: Alternative Transportation and Other Resources.” HealthInAging.org, 2019. healthinaging.org/…/alternative-transportation-a…
- 5Administration for Community Living. “Transportation.” Eldercare Locator, accessed 2026. eldercare.acl.gov/…/Transportation.aspx
- 6Federal Transit Administration. “Are transit providers required to offer reduced transit fares to seniors, people with disabilities, or Medicare cardholders?” U.S. Department of Transportation, accessed 2026. transit.dot.gov/are-transit-providers-required-offer-reduced-transit-fares-seniors-people-disabilities-or-medicare
- 7National Aging and Disability Transportation Center. “ADA & Paratransit.” NADTC, 2024. nadtc.org/…/ada-and-paratransit
- 8Federal Transit Administration. “Frequently Asked Questions” (Americans with Disabilities Act). U.S. Department of Transportation, 2015. transit.dot.gov/…/frequently-asked-questions
- 9Centers for Medicare & Medicaid Services. “Non-Emergency Medical Transportation” (Medicaid program integrity booklet for providers). CMS, 2016. cms.gov/…/nemt-booklet.pdf
- 10Medicaid and CHIP Payment and Access Commission. “Medicaid Coverage of Non-Emergency Medical Transportation.” MACPAC, 2019. macpac.gov/…/Medicaid-Coverage-of-Non-Eme…
- 11Centers for Medicare & Medicaid Services. “Ambulance services.” Medicare.gov, accessed 2026. medicare.gov/…/ambulance-services
- 12KFF. “Medicare Advantage 2026 Spotlight: A First Look at Plan Premiums and Benefits.” KFF, 2025. kff.org/…/medicare-advantage-2026-spot…
- 13National Aging and Disability Transportation Center and USAging. “Volunteer Transportation.” NADTC, about 2019. nadtc.org/…/USAging-NADTC-Volunteer-Tran…
- 14Code of Federal Regulations. “49 CFR 37.125, ADA paratransit eligibility: Process.” Legal Information Institute, Cornell Law School, accessed 2026. law.cornell.edu/…/37.125
- 15Centers for Disease Control and Prevention. “Symptoms of Mild TBI and Concussion.” CDC, 2025. cdc.gov/…/index.html
This article reflects the safety priorities of driver rehabilitation and rehabilitation social work. It is general education, not medical or legal advice. Check with your care team, your transit agency and official sources about your own situation. Reviewed October 2026.
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