What is Non-Emergency Medical Transportation?
Emergency medical transportation is one of the many things that Medicare will cover for those who are eligible. An emergency would be defined as any time your medical needs are immediate, such as having a heart attack or being severely hurt in a car accident. In these types of situations, you may need to be taken to the emergency room by ambulance or even by medical flight. You do not have to be approved prior to receiving this transportation.
But what if it isn’t an emergency?
If you are in need of transportation to a medical appointment that is not considered an emergency by Medicaid, you still might be able to get help if and when you need it. One of the things that Medicaid will cover is rides to and from your doctor’s office, the hospital, or any other medical office for Medicaid-approved care. Since it doesn’t involve an emergency situation, this kind of coverage is known as “non-emergency medical transportation.” They may also provide transportation if you don’t have a working vehicle of your own or don’t have your license. You also might be able to receive help if you have a physical or mental disability or are unable to travel or wait for a ride alone. The coverage for these types of rides could be different based on your individual situation or needs, and you might need to receive approval from your State Medicaid agency to qualify.
Who Can Get a Ride?
Federal rules state that Medicaid beneficiaries may get rides both to and from care providers, as needed. Each state has different rules about when these rides are necessary, so you will need to be sure to check the rules for your state. Normally, you’d get instructions on when rides are necessary and how and when you can schedule them when you enroll in Medicaid. You might have to call a Medicaid caseworker, a ride service, or another agency. No matter what, that contact should:
- Help you decide if you have an immediate need for care;
- Make sure you are eligible for Medicaid;
- Verify you have an appointment with a Medicaid provider;
- Make sure you have no other reasonable way to make it to your appointment; and
- Decide what type of ride Medicaid can provide for your situation.
Based on this information, the contact will either set up the ride you need or will tell you how to do it yourself. Then, a person or ride service that has been approved by the state Medicaid program will transport you to and from your appointment.
Also, if you are enrolled in a care plan managed by Medicaid, the customer service staff will give you some facts about ride benefits.
How Do I Get a Ride?
Depending on your state’s rules and your own needs, rides may be by taxi, car, van, public bus or a subway; it could be solo travel or shared with others. You need to call in advance to set up your ride, and you should also call if you need to cancel. It’s important to remember that the driver is only able to give you or a family member a ride straight to a medical facility and back home.
Make sure you follow the rules so that Medicaid will approve and pay for the ride. Drivers may only be authorized to pick up riders at a specific time, so it’s important to:
- Be ready on time for the pick up; and
- Call the ride service to cancel a ride if you do not need one anymore.
In a few places, ride services might not be paid for the time a driver waits for you to get there or if you don’t show up for planned pickups. There may also be limits on how long a driver can wait for you if you aren’t on time. So if you make a habit of not showing up for pickups, you might have to make some extra calls to the ride service to verify you intend on keeping your appointment. Medicaid might also place some additional restrictions on your ability to get a ride, such as requiring you to only use one ride service to obtain rides.