Medicaid Policy
Medicaid Policy
No Previous Policy
At times, Traditional Medicaid recipients may need medical treatment on multiple occasions during a month. Traditional recipients are not required to schedule all of their medical appointments on the same day in order to receive mileage reimbursement. They may schedule appointment times to meet their individual needs. However, when recipients choose to schedule more than one medical appointment on the same day, recipients are expected to schedule the appointments so as to avoid making unnecessary multiple trips on the same day.
Multiple Trips on the Same Day - Defined
Multiple trips on the same day occur when recipients make more than one round trip to a medical provider on the same day. When recipients travel from one medical appointment to another medical appointment on the same day before returning home, multiple trips have not occurred because the recipients made only one round trip.
Multiple Trips on the Same Day Must be Necessary
When scheduling medical appointments on the same day, recipients are expected to schedule the appointments so as to avoid making unnecessary multiple trips on the same day. When unnecessary multiple trips are made on the same day, only reimburse mileage for the first trip.
To decide if multiple trips on the same day were unnecessary, consider:
Distance to be traveled, and in some cases, the direction from the persons home for each appointment;
Age or medical condition of the recipient;
Whether appointments are for routine visits or urgent care;
Availability of the providers, i.e, a provider may only do appointments at certain times of the day; and
Medical reasons for the multiple trips. Have the recipient explain the reason for the multiple trips to decide if the multiple trips seem reasonable.
If it seems likely that a reasonable person would have scheduled the medical appointments in a same or similar manner and would probably have made multiple trips because of one or more of the above factors, the Traditional Medicaid recipient’s mileage costs for each trip may be reimbursed. However, if it is likely that a reasonable person would not have made multiple trips under the same or similar circumstances,then consider the multiple trips to be unnecessary and only reimburse the recipients mileage costs for the first trip. Also, when a person must travel from a neighboring community, consider the distance to be traveled in relationship to the scheduled appointment times.
Remember that when a recipient has a medical appointment and needs to pick up prescriptions on the same day, they must pick up the prescription either on the way to or from the medical appointment.