While you or a family member may benefit from non-emergency medical transportation, paying for it may be your hang-up. However, you shouldn’t lose all hope just yet; there may be coverage options or payment plans available. Here’s what you should know about NEMT and insurance coverage.
What Is Non-Emergency Medical Transportation?
NEMT is a transportation service for those who need assistance traveling to and from medical appointments, longer distances to be closer to family, or nursing home transfers. While some insurance providers and facilities offer their own form of transportation, third-party companies also provide long-distance non-emergency medical transportation.
While it’s uncommon for insurance companies to offer coverage for NEMT, it’s not impossible. Typically, insurance providers have a set of guidelines the trip must meet for them to cover it. Insurance may cover NEMT for a patient that needs transport to another hospital or facility if they require a specialized service that their current hospital or facility doesn’t offer. NEMT is necessary to protect their health.
With that in mind, coverage isn’t a guarantee, and you should always check with your insurance provider for specific instructions on your policy’s coverage limits.
Medicare parts A and B typically don’t cover NEMT unless the patient needs to go to a hospital or other facility for medical treatment or diagnosis. However, you must know that Medicare coverage is contingent on a doctor’s certification that NEMT is necessary to guard the patient’s health. Even in this case, coverage isn’t always a guarantee.
While many families use NEMT for longer trips than to and from local medical facilities, insurance and Medicare are less likely to cover those trips. However, long-distance NEMT is an excellent service to keep in mind.
Many third-party companies—including our team at TransMedCare—offer payment plans to make it easier to pay for your loved ones to get where they need to be safely.
After exploring what you should know about NEMT and insurance coverage, it should be clear that it’s always best to reach out to your medical coverage provider for direct information on your policy and what you should expect.