Non-Emergency Medical Transportation

NEMT stands for Non-Emergency Medical Transportation. The purpose of the NEMT program is to ensure transportation to eligible MO HealthNet Division (MHD) fee-for-service and managed care health plan participants who do not have access to free appropriate transportation to and from scheduled -MHD covered services. The NEMT program may use public transportation or bus tokens, vans, taxi, ambulance, ride shares, or even an airplane if necessary to get you to your health care appointment. You may also be able to get help with gas costs if you have a car, or have a friend or a neighbor who can take you. The NEMT program must approve this before your appointment.

Tips about getting a ride before using NEMT:

• If your city has public transportation, ask if you can ride the bus to your health care appointment at no cost to you
• Call your Local Community Organizations
• If you can get a ride from another agency, please call them before you call NEMT

If your city has public transportation, ask if you can ride the bus to your health care appointment at no cost to you.

Call your Local Community Organizations.

If you can get a ride from another agency, please call them before you call NEMT.

You must be on MO HealthNet or MO HealthNet Managed Care on the day of your appointment. People in a MO HealthNet Managed Care Health Plan get their NEMT services from the health plan. Some people on MO HealthNet or MO HealthNet Managed Care do not get NEMT services as part of their benefits. The NEMT program will let you know if your benefits do not cover NEMT.

If you need to be away from home overnight, the NEMT program may be able to help with meals and lodging. If a child under the age of 21 needs someone to go along, NEMT will only pay for the child and one parent or guardian. NEMT will only pay for other children or adults to ride along for specific circumstances on a case by case basis. Participants under the age of 17, must have a parent or guardian travel with them.

• An appointment with a health care provider that takes MO HealthNet or MO HealthNet Managed Care.
• An appointment for a service covered by MO HealthNet or MO HealthNet Managed Care.
• An appointment with a health care provider near where you live. If the provider is far away, you may need to say why and get a note from your doctor. There are rules about how far you can travel to a health care appointment and get a ride from the NEMT program.

NEMT will not give you a ride to these services:

• Pharmacy, unless receiving a scheduled vaccine
• Certain Durable Medical Equipment services
• Some Comprehensive Substance Treatment Abuse and Rehabilitation (CSTAR) services
• Developmental Disability (DD) Waiver Services
• Some Community Psychiatric Rehabilitation (CPR) services
• Adult day care services
• Services provided in your home.

School districts must supply a ride to a child's individual education plan (IEP) services and IEP medical related services.

Pharmacy, certain Durable Medical Equipment services, some Comprehensive Substance Treatment Abuse and Rehabilitation (CSTAR) services, Developmental Disability (DD) Waiver Services, some Community Psychiatric Rehabilitation (CPR) services, adult day care services, and services provided in your home. School districts must supply a ride to a child's individual education plan (IEP) services and IEP medical related services.

MO HealthNet fee for service participants should call 1-866-269-5927. You must call at least 3 calendar days before the day of the appointment or you may not get NEMT. You may call this number Monday through Friday, 8 a.m. to 6 p.m. for regular scheduled appointments. You may be able to get a ride sooner if a medical problem comes up and your doctor says you can be seen. For these "urgent care appointments," you can call this number 24 hours, 7 days a week. If you have an emergency, dial 911, or the local emergency phone number.

Participants with MO HealthNet Managed Care need to call the number on your health plan card to set up transportation.

The caller will need the following information when requesting a ride:

• The patient's name, date of birth, address, phone number, and the MO HealthNet or MO HealthNet managed care ID number;
• The name, address, and phone number of where you are going;
• The date and time of the appointment;
• The medical reason for your transportation request;
• The type of MO HealthNet covered service (doctor, dentist, therapy, etc.);
• Special needs of the patient, such as the patient uses a walker, cane, or wheelchair; and
• Tell the NEMT program if you need someone to go along if the patient is under the age of 21. If the patient is under the age of 17, they must have a parent/guardian ride with them.

If your ride is more than 15 minutes late, after the pickup time scheduled during the original request, call 1-866-269-5944. Participants with Managed Care need to call the number on your health plan card.

Call the NEMT program to cancel the ride if you cannot go to your appointment or need to change the date. The NEMT program will give you a ride that meets your needs. You do not get to choose what kind of vehicle or the company that will give you the ride.

Missouri law requires the following:

• Children less than 4 years old or less than 40 pounds must be in an appropriate child safety seat.
• Children ages 4 through 7 who weigh at least 40 pounds must be in an appropriate child safety seat or booster seat unless they are 80 pounds or 4'9" tall.
• Children 8 and over or weighing at least 80 pounds or at least 4'9" tall are required to be secured by a safety belt or buckled into an appropriate booster seat.

If you do not have an appropriate child safety seat or booster seat you must provide this information when you make your reservation and the appropriate child safety seat or booster seat will be provided at the time of transport.

• You have the right to be treated with respect and dignity.
• You have the right to privacy.
• You have the right to exercise your rights without being worried about the way the NEMT program will treat you.

You may not always be happy with NEMT services. You can file a grievance with the NEMT program. All you need to do is call 1-866-436-0457. You can also write MTM, 16 Hawk Ridge Drive, Lake St. Louis, MO 63367.

If you have a Managed Care Health Plan, you need to call your Managed Care Health Plan to file a complaint.

The NEMT program will send you a letter if they do any of the following:

• Deny or give a limited approval of service
• Suspend or end a service already approved
• Deny payment for a service

You have the right to ask for a State Fair Hearing within 90 days from the date of the letter. You may ask anyone such as a family member, your minister, a friend, or an attorney to help you. A decision will be made within 90 days from the date you asked for a State Fair Hearing unless it was an expedited request. For information on a State Fair Hearing, call the Participant Services Unit at 1-800-392-2161 (Toll Free) or 1- 573-751-6527 (at your cost)