Mandatory Passages and Language for MC+ Managed Care Health Plan Handbook, page 12
Non Emergency Medical Transportation (NEMT)
NEMT stands for Non-Emergency Medical Transportation. NEMT can be used when you do not have a way to your health care appointment without charge. We may use public transportation or bus tokens, vans, taxi, or even an ambulance, if necessary to get you to your health care appointment. Your MC+ Managed Care health plan will give you a ride that meets your needs. You do not get to choose what kind of car or van or the company that will give you the ride. You may be able to get help with gas costs if you have a friend or a neighbor who can take you. This must be okayed before your appointment.
Who can get NEMT services?
- You must be in your health plan on the day of your appointment.
- Some people do not get NEMT as part of their benefits. To check, call your health plan.
- They will only pay for one child and one parent or guardian if your child is under 21 and needs to be away from home overnight or needs someone to be with him/her. They will not pay for other children or adults.
What health care services can I get NEMT to take me to?
- The appointment is to a health care provider that is in your health plan or takes MC+ Fee-for-Service.
- The appointment is to a service covered by your health plan or MC+ Fee-for-Service.
- The appointment is to a health care provider near where you live. If the provider is far away, you may need to say why and get a note from your PCP. There are rules about how far you can travel to a health care appointment and get a ride.
- Some services already include NEMT. Your health plan will not give you a ride to these services. Examples are: Comprehensive Substance Treatment Abuse and Rehabilitation (CSTAR) services; hospice services; Mentally Retarded and Developmental Disability (MRDD) Waiver services; some Community Psychiatric Rehabilitation (CPR) services; adult day health care services; and services provided in your home. School districts must supply a ride to a child's Individual Education Plan (IEP) services and IEP medical related services.
- The NEMT program can take you to a durable medical equipment (DME) provider only if the DME provider cannot mail or deliver your equipment to you.
- The NEMT program will not take you to a pharmacy. Many pharmacies will mail or deliver your medicine to you.
How do I use the NEMT program?
Call your health plan. You must call before the day of the appointment or you may not get NEMT. Your health plan will tell you how many days you must call before your appointment. You may be able to get a ride sooner if your doctor gives you an urgent care appointment. If you have an emergency, dial 911, or the local emergency phone number.
