Hemingway App makes your writing bold and clear.
NEMT is a covered Medi-Cal benefit when a member needs to obtainmedicallynecessary services and when prescribed in writing by a physician.
1. Am I qualified for NEMT Transport?
If your physical condition prevents you from using ordinary methods of public or private transportation and transportation is requiredfor obtaining medicallynecessary services, then they are required to provide you NEMT services. MCPs must provide NEMT for members who cannot reasonablyambulate or are unable to stand or walk without assistance. At a minimum, MCPs must authorizethe lowest cost type of NEMT that meets your medical needs. Non-emergency medical transportation services are subject to prior authorization, except for those transferred from an inpatient stay at the acute level of care to an acute care hospital,
2. What if the MCP member is a minor?
If the member is a minor, MCPs must also provide transportation for a parent or guardian. MCPs may arrange NEMT for an unaccompanied minor with the written consent of the minor’s parent or guardian, unless the minor is seeking Minor Consent Medi-Cal services like reproductive care. Before arranging transportation for unaccompanied minors, the MCP must make sure it has received all necessary written consent forms. Parental consent is NOT required for Minor Consent Medi-Cal services.
3. What if I need services that are NOT covered?
For Medi-Cal services outside of the MCP contract, the MCP must make its best effort to refer and coordinate NEMT. MCPs must ensure that there are no limits to receiving NEMT as long as your services are medicallynecessary and you obtained prior authorization for the NEMT.
4. What types of NEMT services are available?
If your medical or physical condition prevents you from using ordinary means of public or private transport and the transportation is required for you to obtainneeded medical care, MCPs must provide the following four modes of NEMT transportation:
i. NEMT / Ambulance Services for:
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Transfers between facilities for members who requirecontinuous intravenous (IV) medication, medical monitoring, or observation
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Transfers from an acute care facility to another acute care facility
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Transport for members who have recently been placedon oxygen (does not apply to members with chronic emphysema who carry their own oxygen for continuous use)
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Transport for members with chronic conditions who requireoxygen if monitoring is required
Litter Van Services
A Gurney /stretcher van is usedfor the purpose ofproviding NEMT for passengers with stable medical conditions who requirethe use of a stretcher or gurney, and which is not routinelyequipped with the medical equipment or personnel required for the specialized care provided in an ambulance.
iii. Wheelchair Van Services
MCPs must provide wheelchair van services when your medical and physical condition does NOT meet the need for gurney van services, but meets any of the following:
You can qualify for wheelchair van transport if you have any of the following conditions AND your doctor submits a signed Physician Certification Statement form (discussed further below):
Service areas: Roseville, Sacramento, elk grove, rocklin, woodland, Davis, galt , Auburn, Placerville, El Dorado Hills, Lodi,Woodland and all counties in california.