What Non-Emergency Medical Transportation Is and Who Provides It

Non-emergency medical transportation (NEMT) is a ride to a medical appointment when you cannot drive yourself and do not need an ambulance. It covers trips to dialysis, chemotherapy, physical therapy, doctor visits, and hospital appointments. The ride is usually provided by a contracted van service, not a taxi or ride-share app.

Who pays depends on your insurance. Medicare covers NEMT if your doctor writes an order saying the trip is medically necessary and you cannot use other transportation. Medicaid covers it in every state, though the rules about what counts as medically necessary vary. Private insurance sometimes covers it; some do not. Veterans may have access through the VA. If you have no insurance, some local agencies and nonprofits run their own transportation programs, though these often have long waiting lists.

The key difference from a regular ride: NEMT requires a medical reason documented by a provider, not just a need to get somewhere. A trip to the grocery store does not count. A trip to your oncologist's office does.

Key Takeaways

  • Medicare and Medicaid both cover non-emergency medical transportation, but your doctor must document that the trip is medically necessary and you cannot use other transportation.
  • You typically book NEMT through your insurance plan or a contracted transportation broker, not by calling the hospital or clinic directly.
  • Most services require you to book at least 24 hours in advance, and some require a week's notice for regular appointments.
  • If you have no insurance, contact your Area Agency on Aging or local senior center to learn about free or low-cost transportation programs in your area.
  • Bring your insurance card and the doctor's order to your appointment; the driver will not transport you without proof of coverage or medical necessity.

How to Get a Doctor's Order for Medical Transportation

Before you can book a ride, your doctor must write an order stating that you need NEMT. This is not a referral to a transportation company — it is a medical statement that the trip is necessary for your treatment and that you cannot use other transportation (your own car, a family member, public transit, or a taxi).

Call your doctor's office and ask for the transportation order. You can do this at your next appointment or by phone. Tell them you need NEMT because you cannot drive or arrange your own ride. The office staff will fill out a form — Medicare calls it a Certificate of Medical Necessity — and either mail it to you or send it directly to your insurance plan. Some offices have the form ready; others may take a few days.

Keep a copy for yourself. You will need to show it when you book the ride and again when the driver picks you up. If your doctor's office says they do not issue these orders, ask to speak to the office manager or billing department — they handle transportation requests regularly.

Booking Through Medicare or Medicaid

If you have Medicare, call the number on the back of your Medicare card and ask which transportation broker serves your area. Medicare does not run the rides itself; it contracts with local companies. The broker will ask for your doctor's order, your appointment date and time, and your pickup address. Most brokers require at least 24 hours' notice, though some ask for a week if you have regular weekly appointments.

The broker will confirm the pickup time and give you a confirmation number. Write it down. The driver will call 15 to 30 minutes before arrival to confirm you are ready. If you miss the ride without canceling at least two hours before, some brokers charge a no-show fee or may refuse future bookings.

If you have Medicaid, the process is similar but varies by state. Some states run NEMT through a single statewide broker; others contract with multiple companies. Call the number on your Medicaid card or contact your state Medicaid office to find out which broker covers your county. Medicaid typically covers more types of trips than Medicare — some states include rides to mental health appointments, pharmacy pickups, and dialysis — so ask what your state covers.

Both programs cover the ride itself at no cost to you. You do not pay the driver, and you do not pay the broker. If someone asks you for money upfront, they are not a legitimate NEMT provider.

Private Insurance and Veterans Benefits

If you have private insurance through an employer or the marketplace, check your plan documents or call the customer service number to ask whether NEMT is covered. Not all plans include it. If yours does, the process is the same: get your doctor's order, call the number in your plan materials, and book the ride.

If you are a veteran, contact your local VA medical center or call the Veterans Health Administration at 1-888-438-6972. The VA provides transportation to VA appointments and sometimes to non-VA providers if the VA referred you. You may be able to use VA-contracted transportation, receive a mileage reimbursement, or in some cases get a ride from a volunteer driver program.

If you have no insurance or your insurance does not cover NEMT, move to the next section.

Finding Transportation When You Have No Insurance

Contact your Area Agency on Aging (AAA). Every county has one, and staff can tell you what free or low-cost transportation programs exist in your area. Some AAAs run their own van services; others refer you to nonprofits or senior centers that do. Call 211 or search the Eldercare Locator at eldercare.acl.gov to find your local AAA.

Senior centers often run transportation programs for members, sometimes free and sometimes for a small donation. Call your local senior center and ask whether they offer rides to medical appointments. Some require you to be a member first; membership is usually free or very low cost.

Nonprofit organizations focused on specific conditions — cancer centers, dialysis providers, Parkinson's associations — sometimes run their own transportation programs or know of local options. If you have a chronic condition, ask your doctor's office whether the clinic or hospital has a transportation program for patients.

Religious organizations and volunteer driver programs also exist in many areas. These are often slower — you may need to book weeks in advance — but they are free. Your AAA can point you toward these options.

What to Bring and What to Expect on the Day

Bring your insurance card and your doctor's order. The driver will ask to see both before you get in the vehicle. If you do not have them, the driver may refuse to transport you, and you will be responsible for finding another way to your appointment.

The driver will pick you up at your home or a designated location at the time confirmed when you booked. Rides are usually shared — you may pick up or drop off other passengers. The trip may take longer than if you drove yourself. Plan to be ready 15 minutes before the scheduled pickup time.

If you need a wheelchair lift, walker space, or other accommodation, tell the broker when you book. Not all vehicles have lifts, so the broker needs to assign the right vehicle to your ride.

If you need to cancel, call the broker at least two hours before your scheduled pickup. Canceling with less notice may result in a no-show fee.

Handling Problems and Disputes

If the driver does not show up, call the broker when ready. Most brokers will send another vehicle or refund the ride. Get the name of the person you spoke to and the time you called — you will need this if you miss your appointment and need to dispute a no-show fee.

If you were charged a no-show fee and believe it was unfair, contact your insurance plan or the state Medicaid office. Explain what happened and provide the confirmation number and the date. Most plans will reverse a single no-show fee if you have a reasonable explanation.

If a broker is consistently late, rude, or unreliable, file a complaint with your state insurance commissioner (for Medicare Advantage plans) or your state Medicaid office (for Medicaid). Include dates, times, and confirmation numbers.

Frequently Asked Questions

Do I have to use the same transportation company every time?

No. Each time you book, you can request a different broker if your area has multiple options. However, most people use the same one because the process is familiar and the broker knows your address and needs. If you are unhappy with your current broker, ask your insurance plan which other companies serve your area.

What if my appointment is cancelled and I need to cancel the ride?

Call the broker as soon as you know, ideally at least two hours before pickup. If you cancel with less notice, you may be charged a no-show fee. Some brokers waive the fee if you provide a doctor's note explaining a medical emergency, so ask.

Can I bring a companion or family member on the ride?

Usually yes, but tell the broker when you book. Some vehicles have limited space, especially if other passengers are already scheduled. The companion typically rides free, but confirm this when you call.

What if I live in a rural area and no broker serves my county?

Contact your Area Agency on Aging or your state Medicaid office. Rural areas often have longer wait times and fewer ride options, but most states have backup programs or mileage reimbursement for people in underserved areas. You may be reimbursed for driving yourself or for a family member who drives you.

Do I need to book rides in advance, or can I call the day of my appointment?

Most brokers require at least 24 hours' notice. If you book with less notice, the broker may not have a vehicle available. For regular weekly or monthly appointments, book all your rides at once — this guarantees a vehicle and often moves you up the priority list.