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Medicaid beneficiaries without access to transportation to their medical appointments are eligible for NEMT. Most states that have expanded Medicaid under the Affordable Care Act (ACA) have chosen to offer NEMT to their Medicaid expansion population as well. States work within the broad federal requirements to establish the specifics of their own NEMT programs.
If beneficiaries cannot reliably travel to and from their medical appointments, their overall care will suffer and they will likely end up incurring higher health care costs through hospitalizations and other more intensive services. This would be a disservice to the beneficiary and to the federal and state taxpayers that fund the Medicaid program.
The cost of a trip varies based on a number of factors including time/distance from a patient’s home to the appointment and back, the mode of transportation required, and the availability of transportation options in a given area. For example, a lengthy trip to a dialysis center for a non-ambulatory or wheelchair-bound patient in a rural area of the nation will be more expensive than a short trip to a primary care provider for an ambulatory patient in a suburban community. States that employ NEMT brokers usually pay a set per-beneficiary fee to the brokers who provide necessary transport to Medicaid beneficiaries using the most clinically appropriate and cost-effective transportation option.
