Transportation Help for Medical Appointments: Medicaid, VA, and Local Programs

Who this helps

This guide is for a caregiver who needs a safe ride plan for medical appointments.

It may help if the person you care for:

• has Medicaid and cannot drive or does not have a working car;
• has a Medicaid managed care plan and needs help booking rides;
• is a Veteran who gets VA care or VA-approved community care;
• needs repeat rides for dialysis, chemo, wound care, therapy, or follow-up visits;
• uses a wheelchair, walker, oxygen, or needs help getting in and out;
• missed care because a ride came late or never came;
• is too weak or confused to travel alone.

This guide does not replace your state’s Medicaid ride rules or your plan handbook. It is a starting point for the calls to make today.

What may pay or help

Different programs solve different ride problems. Use this table to decide where to start.

Who may qualify

There is no single national rule that fits every person. The basic question is: does the person have a covered medical need and no safe, reasonable way to get to care?

For Medicaid rides

CMS says Medicaid covers rides for eligible people to and from Medicaid-approved care. The ride may be approved when the person has no working car, no driver’s license, a physical or mental disability, or cannot travel or wait alone. States decide many details, so the state or plan may ask more questions.

Common ride types may include a car, taxi, van, bus, subway, shared ride, or wheelchair-accessible vehicle. The ride type should match the person’s need. A person who can ride in a regular car may not be approved for a wheelchair van. A person who cannot transfer safely may need a different level of service.

For VA travel help

VA says eligible Veterans may get travel pay if they are traveling for care at a VA health facility or for VA-approved care at a non-VA facility, and they meet at least one VA eligibility reason. Those reasons may include a 30% or higher VA disability rating, travel for a service-connected condition, VA pension, income below VA’s limit, inability to afford travel under VA rules, or certain VA claim exams and approved care.

VA may also pay for some non-Veterans in limited cases. This can include a family caregiver under the National Caregiver Program traveling for caregiver training or support, a medically required attendant, or a transplant donor or support person.

For local ride help

Local programs may use their own rules. Some are for older adults. Some are for people with disabilities. Some are for low-income riders. Some only serve one county, hospital, dialysis center, cancer center, or transit district.

Medicaid rides and managed care scheduling

Medicaid non-emergency medical transportation is often called NEMT. It is for medical rides that are not 911 emergencies.

CMS explains that an emergency ride does not need preapproval. But a ride to a regular medical appointment may need state Medicaid approval. For routine rides, you may have to call ahead, verify the appointment, and show that the person has no other reasonable way to get there.

In some states, the Medicaid agency handles rides. In other states, a ride broker handles rides. In many managed care states, the Medicaid health plan tells you how to book the ride or sends you to a transportation vendor.

State rules matter

This is a national guide, so it cannot tell you the exact booking deadline or ride vendor for your state. Use Medicaid.gov’s state contact page to find your state Medicaid agency. Medicaid.gov also says state Medicaid and CHIP agencies are the first place to ask about eligibility status and benefits.

If the person is over the income limit for Medicaid, the ride problem may connect to a larger Medicaid eligibility issue. Start with your state Medicaid agency. You may also want to read our guide to Medicaid spend-down. If the person may need long-term care Medicaid, see our guide to the Medicaid look-back period.

VA travel pay, VA ride programs, and volunteer transportation

VA has more than one transportation path. Do not stop after one phone call if the first person only talks about mileage pay.

VA Beneficiary Travel reimbursement

VA says eligible Veterans and caregivers can submit travel reimbursement claims for travel to and from approved health care appointments. Claims can include mileage and other travel expenses.

VA says some expenses need preapproval from the local VA health facility. These can include regular transportation such as bus, taxi, rideshare, train, plane, or special mode transportation such as an ambulance or specially equipped vehicle. VA says mileage, parking, and tolls do not require preapproval.

VA says to plan to file within 30 days. Late claims are usually denied. You need a new claim for each appointment. You can file online through BTSSS, by mail, or in person using VA Form 10-3542.

Veterans Transportation Service and volunteer rides

VA’s Veterans Transportation Program includes Beneficiary Travel, Veterans Transportation Service, and Highly Rural Transportation Grants. VA says Veterans Transportation Service helps Veterans who need help traveling to VA health care facilities and authorized non-VA appointments. It also works with community partners.

VA also describes the Volunteer Transportation Network. It was created to help eligible Veterans get to VA or authorized care. Volunteer rides may use government-owned vehicles, donated vehicles, county vehicles, Disabled American Veterans vehicles, public transportation, or contracted transportation.

Local aging offices and 211 can find ride options Medicaid may not cover

Some caregivers are not dealing with Medicaid or VA. Some are waiting for approval. Some need rides to care that is not covered by Medicaid transportation. In those cases, local help matters.

The Eldercare Locator is a public service of the U.S. Administration for Community Living. It connects older adults and families to local services. You can search by location, call 1-800-677-1116, text, chat, or email trained staff.

211 says it can help people identify local resources for transportation to doctor’s appointments. 211 is not a benefit program itself. It is a local referral path. The listings may include senior rides, disability transit, paratransit, volunteer driver programs, gas card programs, county transit, faith-based rides, or disease-specific help.

Ask the clinic social worker too. Dialysis clinics, cancer centers, hospitals, and large specialist offices often know which local ride options work in real life.

Dialysis, chemo, and other repeat rides need a backup plan

Repeat treatment is where transportation problems become urgent. One missed dialysis trip or chemo visit can create a health risk.

If the person has Medicaid, ask for recurring NEMT trips. Give the schedule in writing if you can. Ask whether each trip needs a separate trip number. Ask what happens if treatment runs late.

If the person has VA care, ask the VA travel office whether the trips fit Beneficiary Travel, Veterans Transportation Service, volunteer transportation, or another local VA option.

If the person has Original Medicare and needs ambulance transportation for repeated scheduled trips, ask the doctor and ambulance supplier about Medicare’s non-emergency ambulance rules. Medicare says non-emergency ambulance transportation may be covered when it is needed to treat or diagnose a health condition and any other transportation could endanger the person’s health. Medicare also says repeated scheduled non-emergency ambulance trips may be affected by a prior authorization program.

Wheelchair van issues: what to say before the ride

Wheelchair rides fail when the ride company does not know the real need. Do not only say “wheelchair.” Be exact.

Tell the scheduler:

• whether the person can transfer from the wheelchair to a car seat;
• whether the wheelchair is manual, power, reclining, or extra wide;
• whether the person needs a lift or ramp;
• whether the person needs door-to-door or door-through-door help;
• whether steps, steep ramps, apartment gates, or locked buildings are involved;
• whether oxygen, a service animal, or medical equipment is traveling too;
• whether a caregiver or attendant must ride along.

If the plan sends the wrong vehicle, call the ride company right away. Ask for the trip number, the driver or vehicle type, and a corrected vehicle. If this keeps happening, ask the doctor for a short note that explains the mobility need. Then file a complaint with the ride broker, health plan, or state Medicaid agency.

What to do if the first path does not work

If the first answer is no, slow the call down. Ask what kind of no it is.

• If Medicaid says the person is not eligible: Ask whether the issue is Medicaid eligibility, plan enrollment, covered provider, ride level, advance notice, or missing paperwork.
• If the ride vendor says no: Ask whether the Medicaid plan or state agency can review the denial.
• If the managed care plan denies the ride: Ask for the denial in writing and ask how to file an appeal or grievance. Federal Medicaid managed care rules require a grievance and appeal system, but deadlines and steps vary by state.
• If the VA travel claim is denied: Ask the VA travel office for the reason, whether a missing receipt or preapproval caused the denial, and how to correct or appeal it.
• If no benefit pays: Call the Area Agency on Aging, 211, the clinic social worker, and local disability transit.
• If this is part of a bigger home care need: Ask whether a Medicaid waiver, home care program, or family caregiver program may help. Start with Can I get paid to be a caregiver? and the caregiver pay quiz.

Phone scripts

For more call wording, see our caregiver phone scripts.

About This Guide

CaregiverBenefits.org writes guides for family caregivers who need real benefit paths and next steps. This guide focuses on medical ride help through Medicaid, VA, and local programs. It is not a general caregiving article.