Non-Emergency Medical Transportation Program (NEMT) FAQs
- What is NEMT?
NEMT stands for Non-Emergency Medical Transportation. The purpose of the NEMT Program is to ensure transportation to eligible MO HealthNet fee for service and Managed Care Health Plan participants who do not have access to free appropriate transportation to and from scheduled MO HealthNet covered services. The NEMT Program may use public transportation or bus tokens, vans, taxis, ambulances, ride-shares, or even airplanes, if necessary, to get participants to health care appointments. Participants may also receive help with gas costs if they have a car, or have a friend or a neighbor who can take them. The NEMT broker must approve this before the appointment.
Prior to requesting a ride using NEMT, participants should:
- If the participant’s city offers free public transportation, then the participant should utilize the free public transportation
- Contact local community organizations for assistance
- Secure a ride from another agency, if available
Refer to the NEMT Provider Manual for more information.
- Who can get NEMT services?
Participants must be eligible for MO HealthNet or MO HealthNet managed care on the day of the appointment. Participants in a MO HealthNet Managed Care Health Plan get their NEMT services from the health plan. Some participants on MO HealthNet or MO HealthNet Managed Care do not get NEMT services as part of their benefits. The NEMT broker will let participants know if their benefits do not cover NEMT.
Refer to Section 3.1 of the NEMT Provider Manual for more information on eligible participants.
- What if the trip requires an overnight stay?
If participants 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.
Refer to Section 16 in the NEMT Provider Manual for more information.
- Under what circumstances can a participant request a ride through the NEMT Program?
Participants may request rides in the following circumstances:
- 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 the participant resides. If the provider is far away, the participant may need to say why and get a note from their doctor. There are rules about how far a participant can travel to a health care appointment and get a ride from the NEMT Program.
- School districts must supply a ride to a child's individual education plan (IEP) services and IEP medical related services.
Refer to Section 4 of the NEMT Provider Manual for more information on travel standards.
NEMT will not provide rides to these services:
- Pharmacy, unless receiving a scheduled vaccine
- Certain Durable Medical Equipment (DME) 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 the participant’s home
Refer to Section 8 in the NEMT Provider Manual for more information on non-covered services.
- What number do participants call to request a ride?
MO HealthNet fee for service participants should call (866) 269-5927 at least three (3) calendar days before the day of the appointment. Participants may call this number Monday through Friday, 8:00 am to 6:00 pm for regular-scheduled appointments.
For urgent care appointments, participants can call the number above 24 hours a day, seven (7) days a week. In an emergency, participants should dial 911, or their local emergency phone number.
Participants with MO HealthNet Managed Care need to call the number on their health plan card to set up transportation or visit Contact Your Health Plan for information.
- What information does a participant need when they call (866) 269-5927 to request a ride?
MO HealthNet fee for service participants should call (866) 269-5927 at least three (3) calendar days before the day of the appointment. Participants may call this number Monday through Friday, 8 a.m. to 6 p.m. for regular-scheduled appointments. Participants may be able to get a ride sooner if a medical problem comes up and their doctor says they can be seen. For these "urgent care appointments," participants can call this number 24 hours a day, seven (7) days a week. In an emergency, participants must dial 911, or the local emergency phone number.
Participants with MO HealthNet Managed Care need to call the number on their health plan card to set up transportation.
- What does a participant need when they call (866) 269-5927 for a ride?
The caller will need the following information when requesting a ride:
- Participant’s name, date of birth, address, phone number, and the MO HealthNet or MO HealthNet managed care ID number
- Name, address, and phone number of the medical provider that will be seen by the participant
- Date and time of the medical appointment
- Medical reason for the transportation request
- The type of MO HealthNet-covered service (doctor, dentist, therapy, etc.)
- Special transportation needs of the participant; i.e., the participant uses a walker, cane or wheelchair
Whether the participant is under the age of 21 and needs someone to accompany them to the appointment. If the participant is under the age of 17, a parent/guardian must ride with them.
- Who is required to notify the participant of their ride details and when will the participant be notified?
Transportation providers or the NEMT broker are required to let participants know all trip details no later than 24 hours before the trip. This includes confirmation of the pickup and drop-off address, estimated time of pickup, type of transportation, phone number to call to get a return ride if pick up time was not set during reservation and information on what to do if the ride is late.
- What should a participant do if their ride is late?
Participants should call (866) 269-5944 when their scheduled ride is more than 15 minutes late from the original requested scheduled time.
Refer to Section 17 of the NEMT Provider Manual for more information on Where’s My Ride?
- Who can a provider contact to report a complaint?
If a participant is not satisfied with the services, the NEMT broker has provided, the participant can contact the broker at (866) 269-5927 to file a grievance.
Refer to Section 11 of the NEMT Provider Manual for more information on the provider complaint procedure.
- Who do participants contact for reoccurring issues?
All issues should be reported to the NEMT broker through the Where’s My Ride? line at (866) 269-5927. Complaints can also be reported to any broker representative by stating “I would like to file a complaint.”
If a participant is not satisfied with the services, the NEMT broker has provided. The participant can contact the broker at (866) 269-5927 to file a grievance.
Refer to Section 18 of the NEMT Provider Manual for more information on the participant complaint procedure.
Refer to Section 14 of the NEMT Provider Manual for more information on the participant grievance procedure.
- What are the participant’s rights?
Participants must be given the rights listed below by the transportation broker:
- General rule: The transportation broker must comply with any applicable federal and state laws that pertain to participant rights and ensure that the broker’s personnel and transportation providers take those rights into account when furnishing services to participants.
- Dignity and privacy: Each participant is guaranteed the right to be treated with respect and with due consideration for their dignity and privacy.
- Copy of transportation records: Each participant is guaranteed the right to request and receive a copy of their transportation records.
Free exercise of rights: Each participant is free to exercise their rights, and that the exercise of those rights does not adversely affect the way the broker and the broker’s transportation providers or the state agency treat the participant.
If the participant is in a MO HealthNet Managed Care Health Plan, the participant can call the Managed Care Health Plan to file a complaint.
- General rule: The transportation broker must comply with any applicable federal and state laws that pertain to participant rights and ensure that the broker’s personnel and transportation providers take those rights into account when furnishing services to participants.
- Can a participant choose their transportation provider?
The NEMT broker is responsible for arranging the least expensive and most appropriate mode of transportation based on the participant’s medical needs. However, a participant may request a preferred provider. The NEMT broker will try to schedule transport with the preferred provider; however the broker cannot guarantee the provider will be available for the specific trip.
- Can a participant request not to ride with a specific transportation provider?
The NEMT broker is responsible for arranging the least expensive and most appropriate mode of transportation based on the participant’s medical needs. However, a participant may request not to ride with a specific provider. The NEMT broker will investigate any incident resulting in such a request.
- What if the NEMT broker assigns a rideshare (i.e., Uber, Lyft) for a participant, but the participant does not have texting abilities?
In order for a participant to utilize a rideshare option, they must have the ability to send and receive text messages. If a participant does not have this ability, they should contact the broker at (866) 269-5927 and have rideshare excluded from their file.
- How are the drivers credentialed and trained for these trips?
All approved NEMT broker transportation providers are required to meet a rigorous credentialing process. This process requires all drivers to have a current driver's license, a clean driving record (including the Missouri State Highway Patrol Request for Criminal Record Check and the Family Care Safety Registry) and a negative result on a stringent drug test. Once all the information is received, the NEMT broker's Compliance Department will review to make sure the driver meets all the standards set forth by the state of Missouri. The driver is then either approved or denied to transport participants.
Once approved to transport MO HealthNet participants, each driver must complete specific training related to NEMT transportation. Training, which is administered by the transportation provider, includes several key topics: defensive driving; use of safety equipment; basic first aid and universal precautions for handling body fluids; operation of lifts, ramps and wheelchair securement devices; methods of handling wheelchairs; use of common assistive devices; methods of moving, lifting and transferring passengers with mobility limitations; and instructions on proper actions to be taken in problem situations.
- Are the vehicles used for NEMT inspected on a regular basis?
Along with the driver credentialing process and training, each vehicle operated by a transportation provider must undergo an initial 45-point vehicle inspection by the NEMT broker’s Field Monitor before the vehicle can transport MO HealthNet participants. Once approved, each vehicle is inspected every six (6) months. Wheelchair and stretcher vehicles receive more in-depth inspections with regard to the special equipment needed for transport. Once inspected, a NEMT broker window decal is applied to the vehicle. This provides for a quick visual identification of the broker-approved vehicle.
- What can participants do if an NEMT service is denied?
The NEMT broker should provide prior verbal notification and written notification to the participant within 24 hours of the request. The NEMT broker will send the participant a letter if any of the following occurs:
- Deny or give a limited approval of service
- Suspend or end a service already approved
- Deny payment for a service
Participants have the right to ask for a State Fair Hearing within 90 days from the date of the letter. Participants may ask anyone such as a family member, your minister, a friend or an attorney to help them. A decision will be made within 90 days from the date a State Fair Hearing was requested unless it is an expedited request. For information on a State Fair Hearing, call the Participant Services Unit at (800) 392-2161 (Toll Free) or (573) 751-6527 (at your cost).
Refer to Section 13 of the NEMT Provider Manual for more information on denials.
- What does a participant do if they need to cancel a ride scheduled through the NEMT broker?
Participants should call the NEMT broker at (866) 269-5927 or visit the MTM Link to cancel transportation if they cannot go to their scheduled appointment or need to change the date.
Revised October 2024