One essential feature of federal regulations for Medicaid is the implementation by each state of transportation assistance for Medicaid beneficiaries to enable them to receive health care. Medicaid beneficiaries will need to be able to travel to and from their medical providers’ offices and clinics so that the very central function of Medicaid will be fulfilled. Therefore, Medicaid recipients are eligible for transportation assistance to medical appointments of non-urgent, non-catastrophic nature as covered by their Medicaid Card. This medical transportation assistance provides Medicaid beneficiaries with cost-effective transportation. The options available may include, but are not limited to:
- Bus passes
- Taxi rides
- Non-urgent ambulance rides
- Medical mileage reimbursement
- Special needs rides
- Rides with Department of Human Services Volunteers
States are allowed to cover transportation services to Medicaid recipients either as an administrative expense, or as an optional medical service, and in some cases, both.
Medicaid Transportation Assistance as an Administrative Expense
States are required to utilize the least expensive means, as well as free services where available including volunteer assistance, when using medical transportation as an administrative expense. Each state is allowed the flexibility when handling medical transportation for Medicaid recipients. Instead of providing direct compensation to transportation service providers, a state may provide their Medicaid recipients with bus tokens, gas vouchers or even transportation volunteers. Federal matching funds are issued for 50 percent of whatever cost is incurred of the administrative rates.
Medicaid Transportation Assistance as an Optional Medical Service
Instead of covering transportation assistance as an administrative expense, some states opt to offer it as an optional medical service. In this case, the state makes a direct payment to their Medicaid-approved vendor. The Medicaid beneficiary still has some flexibility when choosing a transportation vendor; however, the state is not required to provide transportation at exceptional cost. When providing Medicaid transportation assistance to beneficiaries, states are still required to utilize low-cost, or if possible, free transportation. Transportation costs claimed as optional medical services and authorized by the state are matched at the state’s federal medical assistance percentage.
Medicaid Transportation Assistance for Children Through EPSDT
The Federal government authorizes that Medicaid services for children include transportation to and from medical providers’ offices or clinics as long as the services are essential to the treatment of a disease, illness or defect, which includes preventive and rehabilitative care, under the Early and Periodic Screening, Diagnostic and Treatment Program or EPSDT. This also allocates for the cost of travel-related expenses including meals, lodging and adult to accompany the child. Travel expenses are covered in situations where in the EPSDT recipient requires medical service that is only available in another city, or State, with a distance and travel time that necessitates an overnight stay. This means that even if a state does not provide medical transportation assistance to adults, all states are mandated to provide medical transportation assistance to children.
Access to transportation services is an important element in ensuring that Medicaid recipients are able to travel to and from their medical appointments to receive the care or treatment necessary for their well-being and health – which is the primary goal of Medicaid in the first place.