Medicaid generally covers transportation to medically necessary appointments, a service formally known as Non-Emergency Medical Transportation (NEMT). This benefit is designed to remove a significant barrier to healthcare access for eligible individuals who lack a reliable way to get to their providers. NEMT is a required service that helps ensure beneficiaries can attend covered medical services.
The Mandate for Coverage
Federal law establishes the requirement for all state Medicaid programs to provide transportation to and from medical appointments for beneficiaries who need it. This mandate is codified in the Code of Federal Regulations, which requires state agencies to ensure necessary transportation for recipients to access covered services. This provision acknowledges that a lack of transportation directly impacts a person’s ability to receive mandated healthcare.
The administration of the NEMT service differs by state, affecting the process for the beneficiary. Some states manage the service directly through a Fee-for-Service model, where the state coordinates and approves each trip. Other states use Managed Care Organizations (MCOs) or contract with third-party transportation brokers. Regardless of the administrative model, the underlying federal requirement is that transportation must be provided when no other means is available for the beneficiary to reach covered care.
How to Request a Ride
The initial step in requesting NEMT is to secure your medical appointment with a Medicaid-enrolled provider, as the transportation is tied to a covered service. After scheduling the appointment, you must contact the entity responsible for coordinating NEMT in your area, which could be your state’s Medicaid office, a specific NEMT broker, or your Managed Care Organization. This contact information is typically provided upon enrollment in the Medicaid program.
For routine appointments, call and schedule the ride at least 48 to 72 hours in advance; some states may require up to five business days for longer travel. When you call, you must provide specific details to the coordinator to ensure the ride is approved:
- Your Medicaid identification number.
- The full name and address of the healthcare provider.
- The date and time of the appointment.
- The reason for the visit.
You must also explain any special needs, such as requiring a wheelchair-accessible vehicle or an attendant. Urgent care appointments, hospital discharges, or life-sustaining treatments like dialysis often have different protocols, allowing for same-day or shorter-notice requests. If the trip is approved, the broker or MCO will coordinate the appropriate mode of transport and confirm the pickup time and location.
Covered Modes of Transport
Medicaid NEMT covers a variety of transportation modes, tailored to the recipient’s medical needs and the most cost-effective option available. For individuals able to travel independently, coverage may include vouchers for public transit, taxi vouchers, or rideshares. Mileage reimbursement is often provided to beneficiaries or their friends and family members who use a personal vehicle to drive to a medical appointment.
For those with mobility limitations, more specialized vehicles are available, including wheelchair-accessible vans equipped with ramps or lifts. In some cases, commercial transit, such as a bus or plane, may be covered for long-distance travel to appointments outside the local area if the required medical service is not locally available. The goal is to provide the least expensive, yet suitable, means of transport.
When Transportation is Not Covered
Non-Emergency Medical Transportation is limited to accessing services covered by Medicaid. Transportation is not covered for trips to non-medical destinations, such as court appearances or social events. Furthermore, the service does not cover transportation solely for picking up prescriptions unless it is part of a covered appointment or specifically allowed under state policy.
NEMT also does not cover transport to providers who are not enrolled in the state’s Medicaid program. While an attendant or escort may be covered if medically necessary for the patient, transport for non-essential family members or companions is typically excluded. Trips involving a medical emergency are not handled by NEMT and require calling emergency services.