All Medicaid Programs |
Obsolete Policy |
There are different modes of transportation to meet the needs of Traditional Medicaid recipients. Non-emergency medical transportation includes: bus passes, personal transportation reimbursement, special bus services (Flex Trans), and LogistiCare Medical Transport for door-to-door services.
Bus Pass- UTA (Wasatch Front) and Cedar Area Transportation Services (CATS) (Cedar City)
Send a bus pass to Traditional Medicaid recipients living within the UTA or Cedar City Transit service areas who need transportation to and from medical treatment and covered mental health services and are able to use the bus.
Bus passes have 12 one-way trips on them (more when the household has 2 or more Traditional Medicaid recipients and when someone needs an attendant.) The bus passes also work on UTA TRAX light-rail trains but not the Front-Runner commuter trains. Individuals in wheelchairs who can get to the bus stops may be able to use the regular bus services.
They should call UTA or the Cedar Area Transportation Services (CATS) to see if the bus they need accommodates wheelchairs.
Each month, Traditional Medicaid recipients may receive as many bus passes as they need to obtain Medicaid-covered services from a Medicaid provider including Prepaid Mental Health Providers. When the client has a medical condition requiring frequent treatment and takes the bus, document this in the case record; do not verify every appointment. Update the continued medical need at each review. If a recipient makes frequent requests for more bus passes, workers may request verification of the medical need for frequent trips or the actual appointments.
Request a monthly card on the authorization screen. Order extra cards, or cards needed only occasionally. Bus passes are mailed and may take 3 to 5 days to arrive. Clients need to plan ahead to be sure they have passes for upcoming appointments. LogistiCare service is not available because someone did not plan for routine medical care.
Bus passes can only be used by Traditional Medicaid recipients and an attendant if needed. Coverage for an attendant to accompany the Traditional Medicaid recipients is allowed for children under age 18 or adults who have an authorized representative. An asterisk will appear next to their names on the bus pass. This tells the driver that these people are allowed one attendant to accompany them. For adults who do not have an authorized representative but who need an attendant due to a physical or mental impairment, require verification that an attendant is needed using the form 478, Verification of Need for an Attendant. Workers may authorize an attendant for up to two months while waiting for the client to return the form 478. The new pass will have an asterisk by the client’s name.
Although Traditional Medicaid recipients are eligible for bus passes, do not order them for recipients who do not want them, or for recipients who are not in a bus service area. Do not order them for recipients who say they will use a personal vehicle to go to appointments. Do not order them for nursing home residents.
Recipients eligible for Non-Traditional Medicaid or UPP programs, and those ONLY eligible for QMB, SLMB, QI, QDWI or Emergency Medicaid are not eligible for non-emergency medical transportation.
When clients need curb-to-curb or door-to-door service because of a disability or medical condition, tell them about UTA Flex Trans Service, LogistiCare Medical Transport services, or mileage reimbursement if they could be transported in a personal vehicle. (See items #2, #3 & #4 below.)
Parents with small children who are eligible for Medicaid may request personal mileage reimbursement instead of bus passes to go to their children's appointments. This is because traveling with small children and strollers, etc., may be too difficult for public transportation. It may also be more cost effective if they must take all the children with them at the same time.
Traditional Medicaid recipients who make infrequent trips for medical services may request mileage reimbursement instead of bus passes if it will be more cost effective. Infrequent trips would be an average of 1-3 trips a month or less (or about $10-$12 or less in mileage reimbursement in a month.) Refer to Sec. 651-3 for more information about when to use mileage reimbursement. If a recipient begins making more frequent trips and can use regular bus services, he or she will need to start using the bus instead of mileage reimbursement.
Do not reimburse mileage for clients who receive bus passes in the same month unless they verify why they could not use their bus pass to get to an appointment. For example: when a client has to travel out of the public transit service area to get needed medical care, or had used the bus passes for routine medical care and then had an urgent care need later in the month. Workers may require verification of appointments before approving mileage reimbursement.
[Note: if a client receiving bus passes frequently requests mileage reimbursement as well, discuss the need for planning ahead and asking for another bus passe during the month. Workers may require verification of medical appointments when someone frequently asks for more bus passes.]
Special Bus Services - Curb-to-Curb: UTA Flex Trans
Special paratransit bus services are available for Traditional Medicaid recipients who have a functional inability to use the regular UTA bus service, need curb-to-curb service, and live in Box Elder, Salt Lake, Weber, Davis, Tooele, or Utah counties. The recipient must obtain a physician's certificate indicating the need for transportation.
If the physician's certificate indicates the person can ride the bus, the recipient cannot receive special bus services.
If the physician's certificate indicates the person can use curb-to-curb service, the recipient is required to apply for paratransit services from UTA Flex Trans along the Wasatch Front.
To schedule an appointment at the UTA Mobility Center to determine functional inability to use buses and Trax, clients should call 801-287-7433 in Salt Lake and Davis Counties; Box Elder, Weber, Utah, Davis and Tooele counties, call 877-882-7272. If you use a TDD, call a relay operator at 711 and then give the above number.
Dial-A-Ride: Call CATS, 1-435-865-4510
Regular Medicaid bus passes are not valid for special bus services. To use special bus services, recipients must have a "Special Medical Transportation Card." Once you have qualified for paratransit services from UTA Flex Trans, call the Medicaid office at (801) 538-6155 or 1-800-662-9651 to request the monthly stickers. The recipient will need to provide the physician's certificate to Medicaid also.
The recipient will then arrange needed trips with UTA Flex Trans.
Specialized Transportation - LogistiCare
When a Traditional Medicaid recipient is denied paratransit services from UTA Flex Trans, is outside the UTA service areas, or the physician's statement says the person needs "door-to-door" services rather than curb-to-curb services, the recipient may be eligible for LogistiCare Services. If the household has a licensed vehicle, the recipient is not eligible for LogistiCare services unless there is no one available to drive or the physician’s statement says that the person cannot be transported in a private vehicle. (Exceptions may be made for clients with chronic conditions that require constant medical attention.) Recipients may receive LogistiCare services for up to four weeks while they are obtaining the physician's statement.
LogistiCare services are available from 7:30 a.m. to 5:30 p.m. Monday through Friday. Some limited services is available on Saturdays and holidays to accommodate dialysis patients. Transportation for urgent care needs is available to free-standing urgent care facilities, doctor's offices or an after-hour clinic from 7:00 a.m. to 11:00 p.m.. Requests for transportation for urgent care needs may be verified with the provider to assure that it is not a prescheduled appointment.
Requests for Logisticare services must be made 3 business days before the transportation is needed. Requests for appointments on Mondays must be made by the previous Wednesday. Recipients should not schedule the transportation several days in advance if they are not sure they will be going to the appointment. Cancellations and rescheduling is costly for the provider and can cause inconvenience to other riders.
LogistiCare provides various methods of transport to accommodate the needs of the recipient. They will provide the most appropriate method of transport based on the needs of the recipient.
To schedule transportation for Traditional Medicaid recipients with LogistiCare Medical Transport, recipients need to call 855-563-4403 weekdays between 8:30 a.m. and 5:30 p.m.
Recipients who will use LogistiCare services need to receive a copy of the Medicaid Transportation Riders Guide. This guide will tell them what information they need to provide to LogistiCare along with the rules and requirements for using this service.
Recipients must tell LogistiCare if they travel with a service animal, or if they have a medically necessary attendant who must travel with them. If the recipient is a child, a parent or guardian may accompany the child. Other family members are not to be transported.
Personal Transportation
Some Traditional Medicaid recipients may receive mileage reimbursement for using personal vehicles (car, truck, etc.) to travel to and from their medical appointments. Traditional Medicaid recipients may also be reimbursed for overnight costs (lodging & food costs) under certain circumstances. The local office will reimburse Traditional Medicaid recipients for mileage and overnight expenses.
When Personal Transportation Costs May be Reimbursed
For specific information on when Traditional Medicaid recipients may receive mileage reimbursement for using personal transportation, and when overnight costs may be reimbursed, refer to the following sections:
Mileage reimbursement for travel within the local area, see section 651-3.
Mileage and overnight costs (lodging & food) reimbursement for travel outside of the local area,see section 651-4.
Mileage reimbursement for multiple trips on the same day, see section 651-5.
Rates and method of reimbursement for mileage and overnight costs for lodging & food, see section 651-6. Limits apply.
Specific Limitations on Reimbursing Personal Transportation Costs
Do not reimburse mileage for portions of a trip an individual travels to pick up the Traditional Medicaid recipient or to return home after leaving the recipient at a medical facility. Reimburse mileage only for the portions of the trip when the recipient is being transported to or from medical treatment.
Do not reimburse individuals who travel to visit a Traditional Medicaid recipient who is receiving medical treatment. The purpose of the trip is to visit and not to obtain a Medicaid covered service from a Medicaid provider, so transportation costs cannot be reimbursed. Reimbursement is only available when the Traditional Medicaid recipient is being transported.
When multiple trips are made on the same day to receive medical treatment, some mileage reimbursement limitations exist. See section 651-5 for more information.
Who May be Reimbursed for Personal Transportation
Either a Traditional Medicaid recipient or an individual who takes a Traditional Medicaid recipient to and from medical appointments may receive mileage reimbursement. Only reimburse mileage for personal transportation used to obtain a Medicaid covered service from a Medicaid provider. Only reimburse actual mileage for trips made to and from medical appointments; i.e., the Traditional Medicaid recipient must be on board going to or from his or her appointment.
When two or more Traditional Medicaid recipients travel together to their medical appointments, the reimbursement amount can only be equal to the mileage rate times the actual miles traveled. Payment for mileage is usually made to only one recipient. If one of the Traditional Medicaid recipients is the owner of the vehicle, the owner should be reimbursed for mileage. If another individual transports two or more Traditional Medicaid recipients at the same time, only the actual miles traveled can be reimbursed and usually just to one recipient. Do not reimburse both recipients for the total miles traveled.
[When reimbursements are done through the EBT system, the reimbursements can only be made to a recipient. When two recipients travel together, though, only reimburse one of them.]