Frequently Asked Questions for Medi-Cal Transportation Services
- Listed: December 13, 2018 4:28 am
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Description
Frequently Asked Questions for Medi-Cal Transportation Services
You can find answers to general questions about nonemergency medical transportation
(NEMT) and nonmedical transportation (NMT) below.
General Information for Medi-Cal Beneficiaries
What is nonemergency medical transportation (NEMT)?
NEMT is transportation by ambulance, wheelchair van, or litter van for beneficiaries who
cannot use public or private transportation to get to and from covered Medi-Cal
services, and who need assistance to ambulate.
Who can receive NEMT?
NEMT is available to all beneficiaries when their medical and physical condition does
not allow them to travel by bus, passenger car, taxicab, or another form of public or
private transportation. Services must be prescribed by a health care provider.
What is nonmedical transportation (NMT)?
NMT is private or public transportation to and from covered Medi-Cal services for
eligible beneficiaries.
Who can receive NMT?
NMT services are available to all beneficiaries with full-scope Medi-Cal and to pregnant
women, including to the end of the month in which the 60th day postpartum falls.
Beneficiaries will need to verbally let the transportation provider know that there is no
other way for them to get to their appointment.
What qualifies as reasons for needing NMT?
Beneficiaries will need to attest to the provider verbally or in writing that they have an
unmet transportation need and all other currently available resources have been
reasonably exhausted.
Reasons for needing NMT can include any of the following:
• No valid driver’s license.
• No working vehicle available in the household.
• Not being able to travel or wait for covered Medi-Cal services alone.
• Having a physical, cognitive, mental, or developmental limitation.
• Not money for gas to get to appointment.
What types of services are covered for Medi-Cal transportation?
Transportation is only available to and from covered Medi-Cal services, which includes:
• Medical appointments, including family planning, mental health, and substance
use disorder services.
• Dental appointments.
• Picking up prescriptions.
• Picking up medical supplies and equipment.
Who can provide NEMT and NMT Services?
Licensed, professional medical transportation companies approved and enrolled by
Medi-Cal. In addition, Medi-Cal managed care plans also directly contract with other
transportation providers for services for plan members.
When should I request transportation?
Be sure to contact your transportation provider as soon as you know about an
appointment. It is helpful to request the service at least three days before your
appointment. If you have more than one appointment that is ongoing, you can also
request transportation to cover those appointments.
Can I accompany my child or spouse to an appointment?
Yes. One assistant, such as parent/guardian or spouse, may accompany a beneficiary
on a trip provided by NMT. However, transportation is not available for more than one
assistant.
Beneficiaries with Fee-for-Service (FFS): How to Obtain Transportation
How can I obtain NEMT?
If you need NEMT, please inform your doctor, who can prescribe NEMT and put you in
touch with a transportation provider to arrange your ride to and from your
appointment(s). The San Diego Field Office can also assist. The San Diego Field Office
may be reached at (858) 495-3666.
How can I obtain NMT?
If you have FFS Medi-Cal, please inform your doctor who may be able to put you in
touch with a transportation provider. You can also go to the DHCS website for a list of
approved transportation providers. The list will soon be available on the Medi-Cal
transportation webpage. See DHCS Transportation Homepage.
Until a list of transportation providers is posted on the DHCS website, DHCS has
developed a process to assist FFS Medi-Cal beneficiaries with their transportation
needs. Beneficiaries or their designees may email DHCS-Benefits@dhcs.ca.gov
requesting assistance if their provider is not able to arrange NMT. Please do NOT
include personal information in your first email. DHCS staff will reply with a secure email
asking for your information about the appointment.
Will Medi-Cal reimburse me for gas/mileage?
Mileage reimbursement, gas cards, tokens, etc. are not covered benefits under FFS
Medi-Cal. However, DHCS is exploring other options regarding the delivery of NMT
services, which may include the use of a contractor, which will be subject to federal
review and approval.
I have a monthly Share of Cost (SOC). Will that apply to NMT?
Yes. If you have a SOC, then your monthly SOC would also apply to NMT. Any
payment you make for NMT will go toward paying down your monthly SOC.
Beneficiaries with Managed Care: How to Obtain Transportation
How can I obtain NEMT?
If you receive Medi-Cal through a managed care health plan (MCP), please contact your
plan’s member service department to request NEMT. You will also need a prescription
from your doctor about your need for NEMT.
How can I obtain NMT?
If you receive Medi-Cal through a MCP, contact your plan’s member service department
to request NMT. Beneficiaries will need to verbally let their MCP know that there is no
other way for them to get to their appointment.
Will Medi-Cal reimburse me for gas/mileage?
No. Medi-Cal does not reimburse beneficiaries who drive themselves to their
appointments. MCPs may reimburse friends or family members of beneficiaries who
drove the beneficiaries to their appointment. Some MCPs may require prior approval for
reimbursement, so please first check with your MCP.
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