All Medicaid Programs |
Obsolete Policy |
Recipients eligible for Traditional Medicaid benefits may receive mileage reimbursement, up to the amount specified in section 651-6, when they use personal transportation to go to and from medical appointments within their local area under the following circumstances:
The personal transportation is used to transport a Traditional Medicaid recipient to or from his appointment for a Medicaid-covered service from a Medicaid provider, (the Traditional Medicaid recipient must be in the vehicle), AND
There is no free transportation available that accommodates the needs of the Traditional Medicaid recipient, AND
A Traditional Medicaid recipient lives in an area where public transportation is unavailable or does not adequately service the persons destination, OR
A Traditional Medicaid recipient living in an area where public transportation is available makes infrequent trips to receive medical services, so it is more cost effective to receive mileage reimbursement instead of getting bus passes. "Infrequent" means either 1) the Traditional Medicaid recipient(s) in the household would make an average of 1-3 trips within the bussing services area a month, or 2) the total medical transportation for the Traditional Medicaid recipient(s) in the household during a month would cost an average of $10-$12 or less in mileage reimbursement, OR
A Traditional Medicaid recipient cannot use public transportation because of a medical impairment including mental limitations or impairments, but can be transported in a personal vehicle OR
A parent must transport small children who are eligible for Medicaid and finds traveling with the small children and strollers too difficult on public transportation. [Mileage reimbursement may even be more cost effective than bus passes when a parent must transport several children at a time for each appointment.] Please be sensitive to the needs of parents with small children, OR
A recipient is eligible for the CHEC program and either drives or is taken in a private vehicle to and from a medical appointment. (Remember that either the recipient or the individual who takes the recipient to a medical appointment may receive mileage reimbursement, but both cannot be reimbursed for the same trip.)
[Medicaid recipients under age 21 automatically qualify for the CHEC program. Medical care under the program includes well-child visits, any follow-up care that may be needed, transportation to and from medical appointments, as well as all other Medicaid covered services. See Section 600 for more information about the CHEC program.]
Exception: When needed services are available locally, Medicaid will not cover transportation unless the recipient receives the services within his or her local area.
In general, "local area" means the community (town, city) within which the person lives, or may be the community closest to the persons home. It does not just mean the zip code area(s) served by the DWS office which has the persons Medicaid case.
For example, a person living in Midvale who sees a doctor at Primary Childrens Hospital or a person living on a farm 3 miles outside of Panguitch who sees a doctor in Panguitch are both still within their local area. However, a person living in Beaver is traveling outside of her local area if she must travel to Cedar City because there is no Medicaid provider in Beaver who can treat her needs.