NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT)

WHAT IS NEMT?

NEMT stands for Non-Emergency Medical Transportation. Most people who have MO HealthNet or MO HealthNet managed care can get a ride to their health care appointments from the NEMT program. The NEMT program can be used when you do not have a way to your health care appointment without charge. The NEMT program may use public transportation or bus tokens, vans, taxi, ambulance, or even an airplane if necessary to get you to your health care appointment. You may also be able to get help with gas costs if you have a car, or have a friend or a neighbor who can take you. The NEMT program must okay this before your appointment.

TIPS ABOUT GETTING A RIDE BEFORE USING NEMT

If your city has public transportation, ask if you can ride the bus to your health care appointment at no cost to you.

Call your Local Community Organizations.

If you can get a ride from another agency, please call them before you call NEMT.

WHO CAN GET NEMT SERVICES?

You must be on MO HealthNet or MO HealthNet managed care on the day of your appointment.

Some people on MO HealthNet or MO HealthNet managed care do not get NEMT services as part of their benefits. The NEMT program will let you know if your benefits do not cover NEMT.

If you need to be away from home overnight, the NEMT program may be able to help with meals and lodging. If a child under the age of 21 needs someone to go along, NEMT will only pay for the child and one parent or guardian. NEMT will only pay for other children or adults to ride along for specific circumstances on a case by case basis.

People in a MO HealthNet managed care health plan get their NEMT services from the health plan.

WHAT HEALTH CARE SERVICES CAN I GET NEMT TO TAKE ME TO?

The appointment is with a health care provider that takes MO HealthNet or MO HealthNet managed care.

The appointment is for services covered by MO HealthNet or MO HealthNet managed care.

The appointment is with 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 doctor. There are rules about how far you can travel to a health care appointment and get a ride from the NEMT program.

NEMT WILL NOT GIVE YOU A RIDE TO THESE SERVICES:

Pharmacy, certain Durable Medical Equipment services, some Comprehensive Substance Treatment Abuse and Rehabilitation (CSTAR) services, Developmental Disability (DD) 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.

HOW DO I USE THE NEMT PROGRAM?

Call 1-866-269-5927. You must call at least 5 calendar days before the day of the appointment or you may not get NEMT. You may call this number Monday through Friday, 8:00 a.m. to 5:00 p.m. for regular scheduled appointments. You may be able to get a ride sooner if a medical problem comes up and your doctor says you can be seen. For these “urgent care appointments”, you can call this number 24 hours, 7 days a week. If you have an emergency, dial 911, or the local emergency phone number.

WHAT DO I NEED WHEN I CALL 1-866-269-5927 FOR A RIDE?

The caller will need the following information when requesting a ride:

WHAT DO I DO IF MY RIDE IS LATE?

If your ride is more than 15 minutes late, call 1-866-269-5944.

DO I HAVE TO PAY FOR THIS SERVICE?

Yes. You must pay $2 for each trip. This $2 will be charged for trips that are one-way or round trip.

If your trip requires more than one stop, you still only pay $2.

Your ride cannot be denied if you cannot pay $2.

You do not pay $2 if you are under age 19, pregnant, blind, or if you live in a nursing home.

You do not pay $2 if you use public transportation, bus tokens, or if you receive help to pay for gas.

WHAT ELSE DO I NEED TO KNOW ABOUT THE NEMT PROGRAM?

If more than two (2) stops are needed before returning home, the transportation provider will get the trip prior approved from the MO HealthNet agency.

Call the NEMT program to cancel the ride if you cannot go to your appointment or need to change the date.

The NEMT program 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.

If your child is not yet 4 years old OR over 4 years old and weighs less than 40 pounds, then you must bring a car seat. If you do not own a car seat, please provide this information when you make your reservation and a car seat will be provided.

PARTICIPANT RIGHTS

You have the right to be treated with respect and dignity.

You have the right to privacy.

You have the right to exercise your rights without being worried about the way the NEMT program will treat you.

You may not always be happy with NEMT services. You can file a grievance with the NEMT program. All you need to do is call 1-866-269-5944. You can also write LogistiCare, 1807 Park 270 Drive, Suite 518, Saint Louis, MO 63146.

WHAT CAN I DO IF A NEMT SERVICE IS DENIED?

The NEMT program will send you a letter if they do any of the following: deny or give a limited approval of service; suspend or end a service already approved; or deny payment for a service. You have the right to ask for a State Fair Hearing within 90 days from the date of the letter. You may ask anyone such as a family member, your minister, a friend, or an attorney to help you. A decision will be made within 90 days from the date you asked for a State Fair Hearing unless it was an expedited request. For information on a State Fair Hearing, call the Participant Services Unit at 1-800-392-2161 (Toll Free) or 1-573-751-6527 (at your cost).