Medi-Cal offers transportation to and from appointments for services covered by Medi-Cal. In this post, we are going to explain in detail how Medi-Cal Transportation works, who is eligible, and how to get free transportation to medical appointments, including wheelchair and litter van.
Table of Contents:
- What are the types of Medi-Cal Transportation Available?
- How do I get California Medi-Cal Transportation?
- California Medi-Cal Transportation FAQs
What are the types of Medi-Cal Transportation Available?
There are two types of Medi-Cal transportation: Nonmedical Transportation (NMT) and Nonemergency Medical Transportation(NEMT).
Nonmedical Transportation
Nonmedical Transportation (NMT) is available to people with full-scope Medi-Cal or who are pregnant, including to the end of the month in which the 365th-day postpartum falls.
NMT is private or public transportation to and from covered Medi-Cal services for eligible beneficiaries.
If you receive Medi-Cal through a managed care plan, contact your plan’s member service department to request NMT.
You will have to attest to your managed care plan that all other currently available resources have been reasonably exhausted.
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 365th day postpartum falls.
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 that 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.
- No money for gas to get to appointment.
Nonemergency Medical Transportation
Nonemergency Medical Transportation (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.
If you receive Medi-Cal through a managed care plan, please contact your plan’s member service department to request non-emergency medical transportation (NEMT).
You will need a prescription from a licensed provider.
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.
How do I get California Medi-Cal Transportation?
Here’s how to request Medi-Cal transportation:
Emergency Medical Transportation
If you need emergency medical transportation, please call “911”.
Non-Emergency Medical Transportation (NEMT)
If you need non-emergency medical transportation under Medi-Cal, here’s what you need to do:
NEMT Medi-Cal Transportation Through MCP
If you receive Medi-Cal through a Managed Care Plan (MCP), your primary care physician (PCP) or specialist will need to complete a Provider Certification Statement (PCS) form prior to receiving transportation.
Each Managed Care Provider (MCP) has its own PCS form.
You can request a form from your doctor by telephone, electronically, in person, or another method established by your MCP.
Once your doctor prescribes the form of transportation, the MCP cannot modify the authorization.
Since it takes a few days to process the request, it is recommended that you call at least 5 days in advance of your appointment.
However, if you have an urgent appointment, you may call as soon as you can.
When you call, you will be asked for your Medi-Cal ID and Health Plan ID information.
NEMT Medi-Cal Transportation Through FFS Medi-Cal
If you have FFS Medi-Cal, please inform your medical provider.
They can prescribe NEMT and find a transportation provider to coordinate your ride to and from your appointment(s).
If your medical provider needs assistance with finding a NEMT provider in the area, please call the San Diego Field Office at (858) 495-3666.
Non-Medical Transportation (NMT)
How you request Medi-Cal Transportation depends on whether you get Medi-Cal care through a Managed Care Provider (MCP) or through Fee-For-Service (FFS).
NMT Medi-Cal Transportation Through MCP
If you receive Medi-Cal through a Managed Care Plan (MCP), contact your plan’s member service department to request NMT.
You will need to verbally let your MCP know that there is no other way for you to get to their appointment.
Call your MCP at least 5 days in advance of your appointment.
However, if you have an urgent appointment, you may call as soon as you can.
When you call, you will be asked for your Medi-Cal ID and Health Plan ID information.
NMT Medi-Cal Transportation Through FFS Medi-Cal
If you get Medi-Cal care through Fee-For-Service (FFS), here’s how to get NMT transportation.
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.
Additionally, beneficiaries or their designees may email [email protected] 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.
California Medi-Cal Transportation FAQs
Here are the most frequently asked questions about California Medi-Cal transportation:
Who can provide NEMT and NMT Services?
Licensed, professional medical transportation companies that are 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.
How do I contact California Medi-Cal Transportation?
If you are a Medi-Cal Transportation provider, you may direct questions about billing to the Telephone Service Center at (800) 541-5555.
For Benefits-related questions, providers may direct inquiries to the [email protected].
How do I file a Complaint about a Medi-Cal Transportation “No Show”?
If you scheduled a Medi-Cal transportation ride and the ride did not show up, here’s how to file a complaint:
Please call the Medi-Cal service center at (800) 541-5555.
Left Behind: Medicaid Patients Say Rides to Doctors Don’t Always Come https://t.co/oRI6k0zHR9 via @khnews
— Edwin Park (@EdwinCPark) January 13, 2022
However, before you file a complaint, first call the number you used to set up your ride.
Stay calm and explain the problem. The ride service should help you.
Then call your medical provider, and explain it to them.
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.
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.
Will Medi-Cal pay for transportation?
Yes. If you’re covered by a Medi-Cal plan, your benefits include free transportation to and from health care appointments.
To qualify, you must have no other way to get to the appointment.
You will have to attest to your Managed Care Provider that you have exhausted all options for getting transportation to and from your appointment.
How much is an ambulance ride with Medi-Cal?
The average cost of an ambulance trip in California ranged between $586 and $673.
Does Medi-Cal cover ambulance service?
Yes. Medi-Cal covers the cost of emergency medical transportation for eligible recipients.
What services are not covered by NMT?
NMT does NOT cover trips to a non-medical location or appointments that are not medically necessary.
Does Medi-Cal reimburse for mileage?
What is a litter van?
A litter van is a modified vehicle that is used for the purpose of providing NEMT for passengers with stable medical conditions who require the use of a litter or gurney, and which is not routinely equipped with the medical equipment or personnel required for the specialized care provided in an ambulance.
California Medi-Cal Transportation Summary
We hope this post on California Medi-Cal Transportation was helpful.
Questions?
If you have further questions about Medi-Cal or Medi-Cal transportation, please let us know in the comments section below.
Be sure to check out our other articles about Medicaid, including:
