In our latest white paper, we discuss how patients access healthcare in a very literal way. How do they get to the doctor’s office? Do they have a way to get their prescriptions even if they are not able to walk up to a pharmacy counter?
Data on patients’ transportation options can be hard to find, especially for patients with commercial insurance coverage. For that reason, our research focused on Medicaid members. Statistically, they are more likely than any other patient population to struggle with transportation insecurity. That means Medicaid beneficiaries are:
- Less likely to own a car,
- Less likely to have access to a car or reliable drivers,
- Less likely to have access to reliable public transportation,
- And are more likely to be homebound due to illness or disability.
People without reliable and consistent transportation are more likely to miss medical appointments, skip preventative care, and abandon prescriptions at the pharmacy. Over time, minor illnesses can become major, chronic, and expensive medical problems without the right care and prescription therapy. This not only hurts the patient, their family, and their community, but also increases costs for the Medicaid plan and taxpayers.
For these reasons, in 2020 the federal government mandated that non-emergency medical transportation (NEMT) must be a benefit under all state Medicaid programs. While states vary greatly in how they deliver NEMT to Medicaid members (as demonstrated in the chart below), we can make a few generalizations about the way this benefit works.
State Medicaid programs want to help patients access their medical care. But to keep costs in check, plans also emphasize that patients should only use NEMT when they have no other option and should use the cheapest mode of transportation that is available and accessible.
Form of Transportation: If the patient uses a wheelchair but local public transportation cannot accommodate them, NEMT will arrange a wheelchair-accessible van. If the patient lives in an area with no public transportation at all, NEMT will cover a taxi. But if a patient lives in a household with a car and there is a reliable person who could drive them to their appointments, NEMT might only reimburse the patient for mileage – and only in certain situations.
Destinations and Scheduling: Rides generally need to be scheduled well ahead of time, but urgent rides are usually available for patients being discharged from the hospital. Some states will allow rides to all Medicaid-covered appointments, whenever needed; others only allow one round-trip ride per day. It’s important to note that not all states allow rides to the pharmacy. Some will allow trips to the pharmacy only in combination with a doctor’s appointment, or only if the patient has no other way to acquire their prescriptions.
Kids: Most states allow children under 16 years old and disabled adults to have one adult escort but do not necessarily allow parents to bring children if the child is not the patient. Obviously, this could make NEMT useless for parents struggling with transportation instability, as they would need to coordinate an NEMT ride and child care simultaneously. There are some exceptions, like Georgia, which leave it up to the transportation broker to decide whether the NEMT vehicle has room for additional children.
NEMT Benefits by State
In some states, Medicaid plans will arrange NEMT with transportation providers themselves. In others, plans will contract with transportation brokers. Regardless, patients may need to call different numbers to arrange rides depending on whether they have a fee-for-service (FFS) or managed care (MCO) plan.
If you would like to learn more about your state’s NEMT benefits, click the link in the “State” column. Please note that many states do not offer up-to-date information, and Medicaid beneficiaries will need to call their plan or provider for assistance.
|State||Benefit basics||How to schedule||Rides to/from pharmacy covered?|
|Alabama||“Covers rides to and from a doctor's office, clinic or other place for Medicaid-covered medical care. The ride can be in your own personal car, a car of a friend, neighbor or family member, or on a bus or a van. You can also get a ride on a city bus or from a group in your town or area.”||Patient must call to schedule a ride within 14 days before appointment.||Unspecified as a covered destination under the scope of services|
|Alaska||“May provide coverage for local ground transportation, e.g., taxi, bus, wheelchair van, for a Medicaid recipient, and escort if necessary, to travel to/from a medical appointment.”||Provider must request authorization at least 1 day before appointment.||Yes, but only in conjunction with a medical, dental, or behavioral health appointment|
|Arizona||“For Medicaid members who do not have their own transportation or means to arrange for their own transportation.”||Patient must call for information.||Unspecified|
|Arkansas||“[Members] may be eligible to get a ride to and from your primary care provider (PCP) appointments or other covered medical services. You do not have to pay anything.”||Patient must call transportation broker to schedule rides.||Unspecified|
|California||“Nonemergency medical transportation (NEMT) is transportation by ambulance, wheelchair van, or litter van for those who cannot use public or private transportation. Nonmedical transportation (NMT) is transportation by private or public vehicle for people who do not have another way to get to their appointment.”||For NMT, patients must request transportation from their doctor or transportation provider. For NEMT, patients must obtain a prescription for transportation from their provider.||Yes|
|Colorado||“If you don’t have a way to get to and from your covered health care services and appointments, you may be able to get a free ride.”||Patients must call IntelliRide, Colorado Medicaid’s transportation provider, to schedule rides at least 2 days before appointment.||Unspecified|
|Connecticut||“NEMT services are only available to HUSKY A, C, D, and limited benefit members that cannot drive themselves, and/or do not have a neighbor, friend, relative, or voluntary organization that can transport them to their appointment. The member must … have no other way of getting there.”||Patients must call Veyo, Connecticut Medicaid’s transportation provider, 2 or 5 days before appointment (depending on level of transportation requested).||Unspecified|
|Delaware||“Only active Medicaid members who do not have alternate means of transportation available to them qualify for non-emergent medical transportation.”||Patients must call Modivcare, Delaware Medicaid’s transportation provider, at least 3 days before appointment.||Unspecified|
|Florida||“Medicaid reimburses for medically necessary non-emergency transportation services for a Medicaid eligible recipient and a personal care attendant or escort, if required, who have no other means of transportation available to any Medicaid compensable service.”||Patients must call transportation provider at least 3 days before appointment.||Unspecified|
|Georgia||“Members must have no other means of transportation available.”||Patients must call the correct transportation broker for their county at least 3 days before appointment.||Yes|
|Hawaii||“Members without access to transportation may be eligible to receive free rides to covered healthcare appointments and quality-of-life services.”||Patients must call IntelliRide, Hawaii Medicaid’s transportation provider, at least 3 days before appointment.||Unspecified|
|Idaho||“If you have a medical appointment but you do not have a car, cannot operate a car, or do not have a friend or family member who can take you, you can request transportation”||Patients must call MTM, Idaho Medicaid’s transportation provider, at least 2 days before appointment.||Unspecified|
|Illinois||“You can go to your doctor’s office, to a clinic or to a hospital as long as you have an appointment and the service is covered by Medicaid.”||Patients must call First Transit, then call the transportation company in their area, then call First Transit again. Some rides will take up to 7 days for authorization.||No|
|Indiana||“Southeastrans provides transportation case management for your Medicaid-covered rides to doctors’ offices, pharmacies or other health care offices.”||Patients must call Southeasttrans, Indiana Medicaid’s transportation provider, at least 2 business days before appointment. Patients may have a copay of $0.50-$2.00, depending on coverage.||Yes|
|Iowa||“The NEMT services are for members with full Medicaid benefits, who need travel reimbursement or a ride to get to their medical appointments.”||Patients must call the transportation vendor for information.||According to 2014 documentation, yes – if the pharmacy does not have a free delivery program OR the pharmacy has free delivery but the patient is picking up the first fill of a new prescription AND the patient has no other way to get to the pharmacy|
|Kansas||“NEMT services are covered if no other ride is available only for the following people: Kan Be Healthy participants; Pregnant women (for pregnancy-related services only); People going for renal dialysis, psychiatric medicine checks, or cancer therapy; People receiving medical treatment more than 50 miles one way or 100 miles round-trip with documentation from your doctor stating medical necessity.”||Patients with a KanCare plan must call the number on their member card to schedule transportation. Patients not assigned to a KanCare plan must call KMAP customer service for information.||No|
|Kentucky||“Non-emergency medical transportation is for Medicaid members who do not have access to free transportation that suits their medical needs”||Patients must call the correct broker for their region to schedule rides.||Unspecified|
|Louisiana||“The medical provider the recipient is being transported to, does not have to be a Medicaid enrolled provider but the services must be Medicaid covered services.”||Patients must call the dispatch office 2 days before appointment.||Unspecified|
|Maine||“You may get a ride to your MaineCare-covered appointment or have your ride reimbursed by MaineCare.”||Patients must call the correct broker for their county at least 2 business days before appointment.||Unspecified|
|Maryland||“Non-Emergency Transportation (NEMT) is available for recipients who have no other means of getting to their medical appointments.”||Patients must call the correct broker for their county at least 24 hours before appointment.||Unclear; documentation states that “Transportation to receive non-medical services” is not covered|
|Massachusetts||“MassHealth is able to provide transportation to MassHealth covered services for eligible individuals. These services include, but are not limited to, medical, dental, mental health, and substance use disorder appointments, as well as transportation to and from Day Habilitation programs.”||Providers must complete an online transportation request. Once approved, patient must contact the correct broker at least 3 business days before appointment.||Unclear; documentation states that “Drivers are not allowed to make any unscheduled stops (such as pharmacies…)”|
|Michigan||“You can get help with a ride if you do not have a way to get to and from a doctor’s appointment or to receive items or services Medicaid covers.”||Patients must contact their plan for assistance.||Yes|
|Minnesota||“NEMT provides Medical Assistance (MA) members with the safest, most appropriate and cost-effective mode of transportation to get to and from nonemergency medical service appointments.”||Patients must submit requests for transportation 3 to 5 days before appointment (depending on level of transportation requested).||Yes, but only “when transport is the only option available based on pharmacy requirements or absence of other means to obtain the prescription(s)” and “Multiple trips per week or per month are not allowed.”|
|Mississippi||“Medicaid will provide transportation assistance to eligible persons for travel to medical appointments when there are no other means of getting to and/or from the appointment.”||Patient must call their plan’s correct transportation provider to schedule transportation.||Unspecified|
|Missouri||“The purpose of the NEMT program is to ensure transportation to eligible… participants who do not have access to free appropriate transportation”||Patient must call to schedule transportation 5 days before appointment.||No|
|Montana||“Medicaid may provide travel assistance benefits to help you get to and from medical appointments.”||Patient must call for approval before arranging transportation.||Unspecified|
|Nebraska||“Non-emergency transportation services are available to members who do not have access to reliable transportation, who cannot drive or secure free transportation.”||Patient must contact MTM, Nebraska Medicaid’s transportation provider, 3 days before appointment.||Unspecified|
|Nevada||“Prior authorization from MTM is required for all non-emergency transportation services.”||Patient must contact MTM, Nevada Medicaid’s transportation provider, 3-5 days before appointment.||Unspecified|
|New Hampshire||“Use NH Medicaid’s Non-Emergency Transportation Program if you need a ride to, or help paying for gasoline to travel to, a Medicaid-covered service.”||Patients must call their plan’s correct transportation provider 2-3 before appointment.||Unclear; yes for members of NH Healthy Families, but unspecified for others|
|New Jersey||Limited information.||Patients must call ModivCare, New Jersey Medicaid’s transportation provider, 2 days before appointment.||Unspecified|
|New Mexico||“Reimbursement is provided when transportation required by recipients to obtain needed medical care cannot be secured without charge through free alternatives… and is the least costly mode of transportation appropriate to the needs of the recipient.”||Only MCOs have provided instructions to obtain transportation.||Unspecified|
|New York||“Medicaid will pay for the most medically appropriate and cost-effective level of transportation to and from services covered by the Medicaid Program.”||Provider must contact Medical Answering Services to request transportation for patient. Rides should be requested 3-7 days before appointment, depending on type of appointment and location.||Unspecified|
|North Carolina||“For all beneficiaries in NC Medicaid Managed Care and NC Medicaid Direct, transportation will be available if the beneficiary receives a Medicaid-covered service provided by a qualified, enrolled Medicaid provider.”||Patients must call their plan or transportation broker to request transportation.||Unspecified|
|North Dakota||“To and from the recipient's home to the closest medical provider capable of providing a medically necessary examination or treatment.”||No information.||Unspecified|
|Ohio||“When medically necessary and patient cannot be transported by any other type of transportation.”||Patient must contact their plan or the Medicaid Transportation Coordinator for their county for information.||Unspecified|
|Oklahoma||“SoonerRide arranges to take you to medically necessary services covered by SoonerCare.”||Patient must call to arrange transportation at least 3 business days before appointment. Patient may bring up to 3 children under the age of 13 with them.||Unspecified|
|Oregon||“Requests for NEMT must be prior authorized.”||Patients must call their county’s correct transportation broker in advance to schedule rides.||Unspecified|
|Pennsylvania||“The Medical Assistance Transportation Program, also known as MATP, provides transportation to medical appointments for Medical Assistance recipients who do not have transportation available to them.”||Patients must call their county’s correct transportation provider in advance to schedule rides.||Yes|
|Rhode Island||“...offer this important benefit for Medicaid members who need to get to and from Medicaid-covered services but have no means of transportation.”||Patient must contact MTM, Rhode Island Medicaid’s transportation provider, 2 business days before appointment. All members with a valid transportation reservation are allowed to bring one (1) additional person.||Yes|
|South Carolina||“Transportation is available for doctor appointments, dialysis, x-rays, lab work, drug store or other medical appointments.”||Patients must call Modivcare, South Carolina Medicaid’s transportation provider, at least 3 days before appointment.||Yes|
|South Dakota||“South Dakota Medicaid covers transportation for Medicaid recipients to medical appointments”||Different requirements for different levels of transportation; patients should see website for information.||Unspecified|
|Tennessee||“Covered as necessary for enrollees lacking accessible transportation for TennCare-covered services.”||Patients must call their plan for information.||Unspecified|
|Texas||“Nonemergency medical transportation services are available for a Medicaid beneficiary or their child.”||Patients must call their plan’s medical transportation number at least 2 business days before appointment.||Yes|
|Utah||“Medicaid may provide reimbursement for non-emergency medical transportation, if you are currently eligible for Traditional Medicaid services and you do not have transportation to get medical care.”||Process varies depending on level of service. Patients should call their plan for more information||Yes, but only on the way to or from a medical appointment with a Medicaid provider.|
|Vermont||“NEMT is a statewide service for providing transports for eligible people to and from necessary, non-emergency medical services. … It must be proven by the member that no other transportation options exist.”||Patients must call the Vermont Public Transportation Association at least 2 business days before appointment.||Yes, but only to the nearest available pharmacy AND if delivery or mailing is not an option.|
|Virginia||“Transportation is covered by Medicaid when you do not have another way to get to your doctor appointment or other Medicaid services.”||Process varies between FFS and MCO plans. FFS members should call ModivCare 5 business days before appointment. MCO members should call their plan for information.||Yes, after medical appointments, according to documentation|
|Washington||“Eligible clients are those in Apple Health (Medicaid and CHIP) and other state-funded medical assistance programs that include a transportation benefit”||Patient must call the correct transportation broker for their county 7-14 days before appointment||Unspecified|
|West Virginia||“NEMT is available to Medicaid members for transportation to West Virginia Medicaid covered services”||Patients must call Modivcare, West Virginia Medicaid’s transportation provider, at least 5 business days before appointment.||Unspecified|
|Wyoming||Information only refers to travel assistance; no information about short-distance transportation||No information.||Unspecified|
If you own a pharmacy or health system and your state's NEMT benefit doesn't include trips to the pharmacy, consider partnering with ScriptDrop delivery. By offering an alternate solution to transportation insecurity, we can work together to reduce prescription abandonment and improve medication adherence nationwide.