Accessing reliable transportation to medical appointments is a critical need for many individuals, especially those enrolled in Medicaid programs. Non-Emergency Medical Transportation (NEMT), Non-Emergency Ambulance Transportation (NEAT), and Emergency Medical Services (EMS) are vital services designed to ensure that beneficiaries can reach необходимый medical care. This guide provides a comprehensive overview of these services, with a particular focus on how to navigate transportation options, including those available through plans like Aetna Better Health.
Understanding Non-Emergency Medical Transportation (NEMT)
Non-Emergency Medical Transportation (NEMT) is a crucial service for individuals who need assistance getting to and from medical appointments but do not require emergency services. This can include routine check-ups, therapy sessions, and specialist appointments. NEMT ensures that transportation barriers do not prevent Medicaid beneficiaries from receiving necessary healthcare.
Accessing NEMT Services
To access NEMT services, Medicaid beneficiaries should typically contact their health plan or the Fee-For-Service (FFS) transportation broker. It’s essential to schedule transportation in advance, ideally at least 48 hours before the appointment.
For beneficiaries with Aetna Better Health of Louisiana, the designated transportation broker is MediTrans. To schedule NEMT services through Aetna, you can contact MediTrans directly at 1(877) 917-4150 or via TTY at 1(866) 288-3133. When you call, be ready to provide details about your appointment, including the date, time, location, and your specific needs.
Other health plans in Louisiana utilize different brokers:
- AmeriHealth Caritas Louisiana: Verida at 1(888) 913-0364 or TTY 1(866)428-7588.
- Healthy Blue: MediTrans at 1(866) 430-1101 or TTY 1(800) 846-5277.
- Humana Healthy Horizons: MediTrans at 1 (844) 613-1638 or TTY 1(800) 618-4781.
- Louisiana Healthcare Connections: MTM at 1(855) 369-3723 or TTY 711.
- United Healthcare Community Plan: ModivCare at 1(866) 726-1472 or TTY 1(844) 488-9724.
For Medicaid beneficiaries not enrolled in a health plan, Verida serves as the Fee-For-Service (FFS) transportation broker. They can be reached at (855) 325-7626.
NEMT Eligibility Criteria
Medicaid coverage for transportation is available when specific conditions are met:
- The beneficiary must be enrolled in a Medicaid program that explicitly includes transportation benefits.
- The beneficiary, or their representative, must declare that they have no other means of transportation available to them.
Covered NEMT Services
NEMT services encompass transportation provided through Local Transit Authorities (like local buses) or NEMT providers contracted with the health plan’s transportation broker. These services are designed to transport eligible beneficiaries to and from medical services covered by Medicaid when no alternative transportation options exist.
Depending on the beneficiary’s health plan, transportation to additional services might be approved. It’s worth noting that beneficiaries eligible for physical health services through Legacy Medicaid are automatically enrolled in a health plan for Medicaid transportation services.
Attendant Requirements for NEMT
For beneficiaries under the age of 17, an attendant is mandatory. This attendant must be a parent, legal guardian, or a responsible adult designated by them, capable of authorizing medical treatment for the minor. Attendants cannot be under 17, Medicaid providers involved in the beneficiary’s care (with exceptions for mental health facility employees in specific situations), or transportation providers.
When transporting children, it is the responsibility of the parent or guardian to provide and ensure the use of appropriate child passenger restraint systems, as mandated by law.
An exception to the attendant rule is made for females of any age seeking prenatal or postpartum care, who are not required to have an attendant.
Meals and Lodging Coverage for NEMT
Medicaid may cover expenses for meals, lodging, and related travel when long-distance travel is necessary for medically essential services. Long distance is defined as trips where the total travel time, including the appointment duration and travel to and from, exceeds 12 hours. This coverage extends to both the beneficiary and one attendant and applies when these costs are not covered by other sources like inpatient per diem or primary insurance.
Important Considerations for NEMT
In case of issues like no-shows or cancellations, healthcare facilities or beneficiaries should immediately contact the MCO or transportation broker. This allows for prompt reassignment of transport services.
Prior approval is generally not needed for standard NEMT services (ambulatory or wheelchair level), unless the destination is out-of-state. For routine NEMT services, aim to make arrangements at least 48 hours in advance, excluding non-business days. Out-of-state medical care transportation may require longer coordination times for approvals.
Understanding Non-Emergency Ambulance Transportation (NEAT)
Non-Emergency Ambulance Transportation (NEAT) is designed for situations where a medical condition necessitates ambulance transport, but it is not an emergency. This service ensures that individuals who cannot safely use other forms of transport due to their health needs can still access medical care.
Accessing NEAT Services
Similar to NEMT, accessing NEAT services involves contacting your health plan or the FFS transportation broker. Advance scheduling of at least 48 hours is recommended.
For Aetna Better Health of Louisiana, you can access NEAT services by contacting them at (877) 917-4150, via email at [email protected], or by fax at (337) 366-6760. Using these dedicated channels ensures that your NEAT request is directed appropriately within the Aetna network.
Contact information for NEAT services through other health plans includes:
- AmeriHealth Caritas Louisiana: (225) 726-2800, email [email protected], or fax (225) 448-2017.
- Healthy Blue: (844) 349-4324, email [email protected], or fax (337) 366-6760.
- Humana Healthy Horizons: (844) 613-1638, email [email protected], or fax (337) 366-6760.
- Louisiana Healthcare Connections: (866) 595-8133, email [email protected], or fax (480) 757-6082.
- United Healthcare Community Plan: (866) 886-4081, email [email protected], or fax (877) 457-3349.
For those not enrolled in a health plan, Verida can be contacted for NEAT services at (225) 726-2800.
NEAT Eligibility Criteria
The eligibility criteria for NEAT mirror those of NEMT: enrollment in a Medicaid program that covers transportation and a declaration of no other available transportation.
Covered NEAT Services
NEAT covers transportation to and from Medicaid-covered services via ground or air ambulance when a beneficiary’s condition contraindicates other transport methods or would risk injury. Although not an emergency, the beneficiary’s medical state necessitates ambulance use.
Certification of Ambulance Transportation (CAT)
A critical requirement for ALL NEAT trips is a completed and valid Certification of Ambulance Transportation (CAT) form. This form must be certified by the beneficiary’s physician, a registered nurse, a nurse practitioner, a physician assistant, or a clinical nurse specialist. The CAT must affirm the medical necessity of ambulance transport and detail the medical condition requiring it. Crucially, the CAT form must be completed before scheduling NEAT services.
Attendant Requirements for NEAT
Attendant requirements for NEAT are identical to those for NEMT, particularly for beneficiaries under 17 years of age, with the same exceptions for females seeking prenatal and postpartum care. Child passenger restraint system responsibilities also apply in ambulances.
Important Considerations for NEAT
Prior approval is mandatory for all NEAT services, including out-of-state destinations. Similar to NEMT, aim to arrange NEAT services at least 48 hours in advance, excluding non-business days, except for urgent requests and discharges. Out-of-state medical care transport approvals may take longer. In case of provider no-shows or cancellations, immediate contact with the MCO or transportation broker is advised to reassign services.
Other Medical Transportation Services
Nursing Facility Ambulance Transportation
Nursing facilities bear the responsibility for providing and funding medically necessary non-emergency, non-ambulance transportation for Medicaid beneficiaries residing in their facilities. This ensures residents can access off-site medical services without transportation barriers.
Emergency Medical Services (EMS)
For situations requiring emergency medical services, always dial 911. Emergency ambulance services (EMS) are available to Medicaid beneficiaries enrolled in programs that explicitly cover emergency transportation.
Gas Reimbursement Program
Louisiana Medicaid offers a Gas Reimbursement Program, allowing family members or friends to transport beneficiaries to Medicaid-covered services and receive reimbursement for mileage. To participate, the gas reimbursement provider must be 18 or older and not reside with the beneficiary. Beneficiaries cannot act as their own gas reimbursement providers. For details, contact your assigned health plan or transportation broker. The phone numbers provided earlier for each health plan’s transportation broker for NEMT can also be used for inquiries about the gas reimbursement program.
Contact Information for Transportation Inquiries
For general transportation inquiries related to NEMT, NEAT, and EMS, you can reach out via email to [email protected].
For specific contacts, you can reach:
- Janessa Baudoin – (225) 342-9566 or [email protected]
- Melanie Doucet – (225) 333-7473 or [email protected]
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This guide aims to clarify the process of accessing medical transportation services, particularly emphasizing Aetna Transportation Services within the broader context of Medicaid in Louisiana. By understanding the different types of services and how to access them, beneficiaries can ensure they receive the necessary medical care without transportation being a barrier. Remember to always verify the most current information with your specific health plan or transportation broker, as policies and contact details can change.
