If you have Medi-Cal coverage in California and need transportation help to and from a health care appointment, we can help. In this post, we will explain how to request Medi-Cal transportation in California.
First, we will explain who is eligible for Medi-Cal transportation.
Next, we will provide details on how to request Medi-Cal transportation if you are under a Managed Care Plan or Fee for Service plan.
Also, we will list the phone numbers for Medi-Cal plan providers.
Lastly, see the eligibility requirements for the various Medi-Cal transportation services available to you.
Table of Contents:
- Who is Eligible for Medi-Cal Transportation in California?
- How to Request Medi-Cal Transportation in California
- Medi-Cal Transportation Phone Numbers
- What types of NEMT Services are Available?
Who is Eligible for Medi-Cal Transportation in California?
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.
This benefit applies to:
- Medical appointments
- Dental appointments
- Mental health appointments
- Substance use disorder appointments
- Trips to pick up prescriptions or medical supplies
- Transportation by wheelchair van, litter van, or ambulance is also covered if needed.
How to Request Medi-Cal Transportation in California
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.
Medi-Cal Transportation Phone Numbers
To arrange a Medi-Cal Transporation ride, start by contacting your Medi-Cal plan provider.
We have provided the phone numbers below for Medi-Cal plan providers.
Be sure to call at least seven days before your appointment.
When you call, have your Medi-Cal insurance card number on hand when you call.
- Alameda Alliance for Health: (866) 791-4158
- Anthem Medi-Cal: (877) 931-4755
- California Health & Wellness: (877) 658-0305
- CalViva Health: (855) 253-6864
- Central California Alliance for Health: (800) 700-3874, ext. 5625
- Contra Costa Health Plan: (855) 222-1218
- Health Net Medi-Cal: (855) 253-6863
- Health Plan of San Joaquin: (209) 942-6320
- Health Plan of San Mateo: (844) 856-4389
- Molina Healthcare: (888) 994-4833
- Partnership HealthPlan of California: (888) 828-1254
- San Francisco Health Plan: (415) 547-7818, ext. 7080
If you have questions related to your plan, please call the Medi-Cal service center at (800) 541-5555.
Enrollees who have used Medi-Cal’s non-medical transportation (NMT) benefit reported that NMT is the main source of transportation to their medical appointments and that transportation supports are critical to maintaining their health. https://t.co/CtSN7ElueD
— CHCF (@CHCFNews) December 23, 2020
What types of NEMT Services are Available?
If your medical or physical condition prevents you from using ordinary means of public or private transport and the transportation is required for you to obtain needed medical care, MCPs must provide the following four modes of NEMT transportation:
1. NEMT Ambulance Services for:
- Transfers between facilities for members who require continuous intravenous (IV) medication, medical monitoring, or observation
- Transfers from an acute care facility to another acute care facility
- Transport for members who have recently been placed on oxygen (does not apply to members with chronic emphysema who carry their own oxygen for continuous use)
- Transport for members with chronic conditions who require oxygen if monitoring is required
2. Litter Van Services
MCPs must provide litter van services if your medical and physical condition does NOT meet the need for NEMT ambulance services, but meets both of the following:
- Requires that the member be transported in a prone or supine position because he/she is unable to sit for the duration of the transport; AND
- Requires specialized safety equipment above and beyond what is normally available in passenger cars, taxicabs, or other forms of public transportation.
iii. Wheelchair Van Services
MCPs must provide wheelchair van services when your medical and physical condition does NOT meet the need for litter van services, but meets any of the following:
- You cannot sit in a private vehicle, taxi, or other form of public transportation for the period of time needed to transport; OR
- You must be transported in a wheelchair or assisted to and from a residence, vehicle, and place of treatment due to a disabling physical or mental limitation; OR
- Requires specialized safety equipment above what is typically available in passenger cars, taxis, or other forms of transportation
You can qualify for wheelchair van transport if you have any of the following conditions AND your doctor submits a signed Physician Certification Statement form (discussed further below):
- Severe mental confusion
- Paraplegia
- Dialysis recipients
- You have a chronic condition that requires oxygen but do not require monitoring
iv. NEMT by Air
MCPs must provide NEMT by air when it is necessary because of your medical condition or because ground transportation is not practical.
Your doctor, dentist, podiatrist, mental health, or substance use disorder provider must submit a written order explaining why air transportation is necessary.
How to Request Medi-Cal Transportation Summary
We hope this post on How to Request 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:
