How Does Medicaid Transportation Work?
- Medicaid provides limited assistance with medically necessary transportation. Find out about Medicaid transportation coverage, requirements and limitations.
Did you know that Medicaid pays for transportation to and from medical appointments? Millions of Americans who participate in the Medicaid program routinely get free round-trip rides for medically necessary hospital and office visits, as well as for other trips related to covered health services. Some restrictions apply to this service, but approved Medicaid transportation helps countless Americans get the care they need without limits imposed by restricted mobility.
Signing Up for Medicaid Transportation
Almost all Medicaid beneficiaries are eligible for Medicaid transportation benefits, provided the requirements are met in your state. Because medically necessary transportation is one of the benefits Medicaid offers to all of its enrollees, there aren’t any special steps you have to follow to sign up for it. Simply apply for Medicaid as you normally would, wait for notification that your application has been approved and then schedule a trip. Be prepared to give the transportation company your information, including your Medicaid ID number, so they can properly bill the program for the services they provide.
Medically Necessary Services and Ride Authorization
All trips deemed medically necessary are authorized by Medicaid, though what counts as necessary may vary by state or on a case-by-case basis. As a rule, your ride is necessary if you must travel to the hospital, a medical office visit, urgent care center or other medical or dental provider. In most states, this includes rides to chiropractors and pharmacies. The ride may be a single trip, such as a visit to the doctor for a checkup, or it may be a continuing series of rides, as with dialysis or chemotherapy recipients. In many states, the doctor has to agree that you needed the ride and could not have used your own transportation for some valid reason, which often includes taxis, buses and rideshares.
If you are already a Medicaid enrollee, you generally do not have to do anything extra to get Medicaid transportation benefits. If you haven’t enrolled yet, but you think you may be eligible, it is possible that the cost of your ride can still be covered by Medicaid. Medicaid in many states will issue payment for services rendered up to 6 months prior to the date you apply for the program, which could greatly reduce the cost of your ongoing medical transportation bills.
What Kinds of Transportation Options Are Available?
Medicaid transportation benefits are available for all levels of transit services, provided they are medically necessary and that the provider is authorized to bill Medicaid. As a rule, Medicaid will pay for the lowest level of transportation that is adequate to meet your safe transit needs.
Assisted Taxi/Disabled Ride
Assisted taxis and disabled ride vans are the basic non-emergency medical transportation service. These ADA-equipped vehicles are appropriate for riders who can walk, walk with assistance or who use a wheelchair to get around. Almost all disabled ride vehicles carry a company wheelchair to help you if needed. Some vans in this class have gurneys that can carry people who need to lie down, or who cannot use a wheelchair for any reason.
BLS/ALS Ambulance Transportation
Basic and advanced life support are provided by EMTs and paramedics on ambulances. These are the lights-and-sirens vehicles that respond to 911 calls and provide specialty transport between medical facilities. A subset of this class includes mobile intensive care units and pediatric life support vehicles, both of which carry a specially trained nurse.
Paying for the Ride
Medicaid automatically pays for any approved trip that has been authorized by a doctor or other qualified practitioner. The ride does not have to be authorized in advance, except in special circumstances, though it does have to be booked with a transportation company that is authorized to bill Medicaid in your state.
Each transportation provider has its own process for billing Medicaid transportation services for your ride, but the general outline is the same nearly everywhere. When you get to the medical office or hospital, your driver can present a Medicaid approval form to the doctor or charge nurse to fill out. This form has sections to identify you as a Medicaid enrollee, lists the condition or reason why you could not have used your own car or public transportation, and has a signature line for the doctor to authorize the trip. The driver who picks you up after the trip takes a copy of this form to bill Medicaid.
Under no circumstances can a Medicaid-authorized transportation provider send you a bill, even if Medicaid ultimately rejects payment for the trip. Be aware, however, that not every transportation provider is able to accept payments from Medicaid. If the company that gives you a ride doesn’t take Medicaid, you will likely be billed for the private-pay cost of your trip, which may run from $50 to several hundred dollars, depending on the distance and level of service provided. Be sure to tell the person booking your ride that you have Medicaid before scheduling the trip.
How to Schedule Medicaid Transportation
Because Medicaid pre-authorizes beneficiaries and transport companies as part of the initial enrollment process, the program doesn’t impose many restrictions on how you book your trips, provided the company you pick is an authorized provider. Perhaps the simplest way to schedule a ride is to just call the company directly. Many small companies offer assisted taxi and disabled ride services, with several more offering ambulance services in every major city. Virtually all of these take orders over the phone from potential riders.
If you book the ride yourself, try to call as far in advance of your appointment as you can, and mention physical or other disabilities you have that could require special accommodations. Most disabled ride companies can meet you with a wheelchair, gurney, oxygen or personal attendant if you need them. Alternatively, if you live in an assisted living community, your concierge or discharge planner probably has a number of companies the facility works with that are known to be reliable and comfortable for their residents.
Some state programs offer assistance with booking Medicaid transportation. If you participate in a local senior group, medical needs-based community or support group, church group or other association, ask whether one of the volunteers or staff can arrange rides for you that fall within the Medicaid transportation boundaries.
If you think you are having a medical emergency, call 911 without delay. Medicaid pays for all emergency medical transportation deemed necessary for its beneficiaries, and there is no penalty for occasional false alarms. Nearly every licensed emergency provider can bill Medicaid in the states where they operate, as can your local fire department or other emergency services provider. In this case, authorization for the trip can be signed off on by the admitting physician at the emergency department.