Medicaid recipients typically have to meet certain criteria in order to receive NEMT services. NEMT services are often received at no cost to them. The elderly and those with disabilities are among the majority of NEMT services. The process typically involves claims processing for new clients, scheduling the trip in advance and the dispatch of the vehicle. NEMT services are justified on the grounds that, compared to the increasing costs in medical care, they are a major cost-save. Also, the fact that something like NEMT is in existence helps to reduce the effects of chronic and terminal diseases.
As Medicaid programs vary from state to state, so do the waivers. The basic clientele requirements for NEMT services are no valid driver’s license, doesn’t own a functioning vehicle, has a physical or mental disability or limitation and/or is not able to wait or travel alone. There is also something called means-testing involved, which is basically an evaluation of the client’s income and listed assets against the income. Risk of life-threatening symptoms, such as heart attacks or uncontrollable bleeding are also heavily considered. Prior authorization is required as there have been various issues in the past of drivers claiming loaded mileage for no-show clients, which is illegal.
The obligations of the State Medicare Agency with NEMT include that the vehicle is able to make the necessary travel, overseeing the coverage for the transportation and to ensure that the most appropriate vehicle is provided. For example, for a client in a wheelchair, a vehicle with a lift would be the most likely to be dispatched to that particular individual’s home. It makes for an easy roll-in for the client and also saves the transport staff a lot of the physical weight and the time that it takes to transfer that individual from the wheelchair to a seat within the vehicle.
Receiving NEMT may be a process that will take some paperwork but for those who have chronic conditions and can’t drive, it’s well worth it. All NEMT services believe that all of their clients deserve to live the longest, healthiest life that they can and are more than glad to assist with this.