When the Medicaid Program was established, the federal government recognized that unless needy individuals could actually get to and from providers of services, the principle of the Medicaid Program is inhibited at the start. As a result, States are required under federal regulation to assure necessary transportation for Medicaid beneficiaries to and from medical services. For the Medicaid population, getting to and from medical services can be a struggle. New York State made the decision to cover medical transportation for Medicaid beneficiaries traveling to Medicaid-covered services.
When traveling to medical appointments, a Medicaid beneficiary is expected to use the same mode of transportation as the beneficiary uses to carry out the activities of daily life. Generally, this mode is public transit or a personal vehicle. However, for some Medicaid beneficiaries, their medical condition necessitates another form of transport, such as an ambulette. In these circumstances, Medicaid will pay for the most medically appropriate and cost-effective level of transportation to and from services covered by the Medicaid Program. All non-emergency transportation must be authorized prior to payment; only emergency ambulance transportation can be reimbursed without a prior authorization.
It is also the enrollee’s responsibility to schedule their medicaid transportation as far in advance as possible in order to accommodate all needs. When scheduling a trip an enrollee is to have the following information available for the call taker:
Reason for the transportation
Date and time of appointment
Location you will be attending
Transportation vendor with whom you prefer to ride
Any other special instructions needed for the trip
To arrange Medicaid transportation call 1-866-753-4430