Medicaid Transportation Essentials
Medicaid transportation is essential for many patients that need transportation to and from non-emergency medical services, but are unsure of the specifics. This guide will help anyone new to the program understand how it works and who qualifies to use the services provided by Medicaid.
What Is Medicaid Transportation?
When immediate care or attention is needed, such as for a stroke, heart attack, or another serious injury, Medicaid does provide coverage for emergency medical transportation. In cases like this, the patient or their carer should simply call for an ambulance from emergency services. This doesn’t always apply to the transportation needs of those on Medicaid, however.
Medicaid transportation is included with Medicaid coverage for eligible individuals. It serves to help arrange transportation for individuals who need medical transportation to or from Medicaid-approved care appointments.
Cases like this are considered to be non-emergency transportation needs and are covered by Medicaid’s non-emergency medical transportation program. This is also one of the reasons that Medicaid transportation has some limits regarding when rides are available, to whom, and for what purposes.
Who Is Eligible For Medicaid Transportation?
You may qualify for Medicaid transportation in many different situations. The regulations set forth for the Federal program state that any Medicaid beneficiaries can get approval for a ride. However, since state-level agencies will set their own rules, always make sure you check with them as well for any limitations or eligibility rules.
In most cases, when you receive your enrollment information there will be information on Medicaid transportation. It should detail for you when a ride is necessary, as well as when and how to schedule a ride or your appointment. Sometimes, to clarify eligibility or scheduling needs, you may need to speak with a caseworker or other agency partner.
If you do need to contact another party, such as a Medicaid caseworker or ride provider, they should be able to help you in several ways. They should be able to:
● Help you make a determination of whether urgent care is needed instead
● Verify your eligibility with Medicaid
● Verify with your Medicaid provider that you have an appointment, and when that appointment is for
● Help you double-check that you have no other reasonable or affordable way to get to your scheduled appointment
● Help you determine the best ride type that can be provided in your situation
Once all of this has been covered, and there are no other options readily available, a decision will be made regarding the transportation. This will usually be either the confirmation of the ride you need or further information on how to set up your ride.
How Does Medicaid Transportation Work?
Only state and Medicaid-approved ride services and drivers are used for Medicaid transportation. Additionally, remember that your Medicaid transportation is only to be used for driving from your home to the appointment, then back. If you deviate from the approved locations, what follows could include charges of stealing from Medicaid.
The exact situation will be unique for each individual, but there are some elements that will remain the same. The first step will be to contact your rider provider to schedule your ride if it has not been done for you already.
Once your ride is scheduled, be sure you notify the ride service of any changes that are needed. For instance, if your appointment was canceled or rescheduled, be sure you advise them of the change. In some cases, the ride is only approved for certain hours and a reschedule can affect that.
Be sure you are ready on time and in the pickup location on the date of the ride. By following the Medicaid process closely there will be a far greater chance that the ride will be approved and paid for. Sometimes, Medicaid will not pay charges for drivers that had to wait too long.
If you are at your pickup location and your ride does not come within a reasonable amount of time, there is a process to report it. Simply call your ride provider and calmly let them know what happened.
On the other hand, if you do not show for your rides it will begin to affect your ability to get ride service. In some cases, you may need to make additional verifications that you will be there. Other situations may result in the applicant being restricted in their ability to get rides approved, or even use a single service for all future rides.
Depending on the local laws and rules, your Medicaid transportation may be provided by one of many possible methods. You may ride in a taxi, or you may ride in a car or van provided by a livery service, while other options include the subway or even a public bus in some cases. You may have private transport or share it with others.
Levels Of Transportation
There are different levels of transportation that Medicaid transportation may pay for, from private vehicles and public transportation to specialized vehicles like ambulettes or vehicles for hire.
One of the most popular methods of Medicaid transportation reimbursement is reimbursement for privately owned vehicles. This is where you or another authorized driver is able to take your vehicle or one owned by them privately, and Medicaid will reimburse a set amount for mileage and expenses.
There are also some states that allow one private party to drive for another. In states like this, there are private companies that are Medicaid-approved to provide Medicaid transportation services. This is similar to a taxi, but it can be any variety of newer vehicles.
In some cases, there are public transportation modes available and the only hurdle is the cost. Situations like this may leverage bus lines, subways, or even elevated trains to get the patient where they need to be. In this scenario, Medicaid will reimburse for the cost of the fare needed to accomplish the errand or make the appointment.
Conventional taxis can be used in some circumstances and locations. These may be an option in suburban areas without access to other public transportation or private vehicles.
Assisted taxis may be one of the more popular ride types in urban areas with mobility challenges. They also need only a minimal amount of planning ahead.
In most cases with assisted taxis that are paid by Medicaid, they will work directly with the ride provider. There may be some situations, however, where you will need to pay for the ride and the Medicaid transportation system will reimburse the expenses.
In situations where taxi service is selected, there are often a variety of accessible vehicles that can be sent depending on the needs of the enrollee. Many taxi companies operate vans and minivans with accessibility features which make them prime candidates to fill transportation needs.
An ambulette is one step away from being a full ambulance. However, they are made from converted vans and are for non-emergency medical transport only. There are some situations where an ambulette is desired for ease and some situations where it may be mandatory for accessibility. These situations include:
● The Medicaid enrollee needs transportation in the recumbent position.
● The Medicaid enrollee requires the use of a wheelchair and is unable to use a taxi, livery or driver service, private vehicle whether owned or loaned or public transportation.
● The Medicaid enrollee is disabled to a degree that requires the use of a walker or crutches, and they are unable to use a taxi, livery or driver service, private vehicle, or public transportation.
● The normally mobile and ambulatory Medicaid enrollee requires radiation therapy, chemotherapy, or dialysis treatments, or any other treatment which may result in a disabling post-treatment physical condition, limiting access to any other traditional transportation options.
● The Medicaid enrollee has a disabling mental condition requiring personal assistance provided by an ambulette service.
● The ordering practitioner certifies in a manner designated by and submitted to the Department that the Medicaid enrollee cannot be transported by a taxi, livery or driver service, private vehicle, or public transportation, necessitating the use of an ambulette service.
Private or public ambulance services may be needed in rare circumstances. Generally, if the Medicaid enrollee is not able to be moved with ease, or needs to remain closely monitored, an ambulance may be an option.
Ambulance service needs to be approved well ahead of time and will require the enrollee to require official ambulance transportation. This is often due to other methods not being able to maintain the level of care that an ambulance is equipped for.
Where can I go with Medicaid transportation?
Nearly any medical appointment or a medically-related appointment can be attended with Medicaid transportation. This includes not only your primary care physician but also appointments for countless therapies and treatments. You can even get your dental care accomplished by leveraging Medicaid transportation.
Order A Medicaid Transport
If you or someone you care for needs to order Medicaid transportation, reach out by phone at 1-844-666-6270 or fax at 1-315-299-2786, or online at medanswering.com.