Non-emergency medical transportation (NEMT) provides rides to covered medical appointments for people who do not have transportation access. NEMT is required by Medicaid law, so state Medicaid programs must provide access to NEMT services. However, the specific NEMT requirements can vary by state.
Verifying Eligibility for NEMT
To utilize NEMT services, you must first verify that you are eligible. Eligibility differs based on your state’s Medicaid program but often includes:
- Having active Medicaid coverage
- Having a medical appointment at a covered healthcare provider/facility
- Not having access to transportation for the appointment
- Obtaining prior authorization for the NEMT ride
- Medicaid contracts with brokers and transportation providers to coordinate and deliver NEMT services.
- You will need to request rides through your Medicaid program’s approved NEMT broker.
Covered NEMT Services
NEMT covers ground transportation to any Medicaid-covered medical appointment. This includes rides via:
- Bus passes or tickets
- Rideshares like Uber or Lyft
- Wheelchair vans
- Ambulances for emergency transport
- You must use the most cost-effective NEMT option suitable for your medical condition. Luxury transport services are not covered.
Scheduling Your NEMT Ride
To schedule a ride through a NEMT company, you can provide details on your appointment date/time, pickup/drop-off addresses, and any mobility accommodations needed. Modern NEMT companies use software like RouteGenie to schedule and dispatch your ride because it automates all non-emergency medical transportation processes including routing, scheduling, dispatching, and billing.
You will receive confirmation of your scheduled ride. Be sure to call if you need to reschedule or cancel a ride to avoid penalties. Drivers will only wait 5-10 minutes past the scheduled pickup time before marking you as a no-show.
NEMT Coverage Limitations
NEMT only covers transportation to medical appointments and related services prescribed by your healthcare provider. Trips for non-medical reasons like grocery shopping will not be approved.
There are also mileage radius limits – most NEMT services are only approved for rides within 50 miles. Longer distances may require special approval.
Stay up-to-date on your state’s specific NEMT requirements to utilize these transportation benefits fully. Reach out to your Medicaid office or NEMT broker with any questions.