FAQ

NEMT is a benefit that ensures people without access to transportation can travel to necessary healthcare appointments. It’s a required benefit in the Medicaid program, helping manage the health of beneficiaries and preventing more expensive forms of care.

Medicaid beneficiaries without access to transportation to their medical appointments are eligible for NEMT. Most states that have expanded Medicaid under the Affordable Care Act (ACA) offer NEMT to their Medicaid expansion population.

The level of service varies based on a beneficiary’s needs and circumstances. Transportation options include;

• Public transit
• Simple car or van transport
• Wheelchair-accessible transportation

NEMT covers various medical visit types, including:

• Dialysis services for patients with End-Stage Renal Disease (ESRD)
• Substance abuse counseling sessions
• Behavioral health or mental health appointments
• Visits with primary care physicians or specialists
• Chemotherapy or other recurring infusion treatments

The cost varies based on factors like time, distance, mode of transportation, and availability of options. States employing NEMT brokers usually pay a set per-beneficiary fee.

Home health care provides skilled health care services in the comfort of your own home. It helps patients recover from illness, surgery, or injury, and manage chronic conditions. Services include skilled nursing care, physical therapy, occupational therapy, speech therapy, and medical social work.

To be eligible, patients typically need to:

• Be homebound, meaning their condition prevents them from safely leaving home without assistance
• Require skilled nursing care or therapy on an intermittent basis
• Have a doctor’s prescription for home health care

Home care agencies offer various services, including:

• Personal Care:
  • Assistance with bathing, dressing, and grooming
  • Meal planning and preparation
  • Light housekeeping and laundry
• Medical Services:
  • Skilled nursing care
  • Physical, occupational, and speech therapy
  • Medication management and reminders
  • Wound care and pain management
• Support Services:
  • Transportation to appointments
  • Socialization and companionship
  • Respite care for family members

Here’s what you can expect:

• A doctor prescribes home health care services
• A home health care company develops a personalized care plan
• Skilled professionals visit the patient at home to provide services
• The care plan is adjusted as needed based on the patient’s progress

Home health care offers many benefits, including:

• Faster Recovery: Patients recover faster in the comfort of their own homes
• Improved Independence: Patients regain independence and self-sufficiency
• Cost-Effective: Home health care can be less expensive than hospitalization or long-term nursing home care
• Personalized Care: Patients receive tailored care from skilled professionals

• How soon can services start? Services can start within days of initial contact, depending on the agency and patient needs.
• Is there a long-term contract? Many agencies don’t require long-term contracts, offering flexible care options.
• How do agencies choose caregivers? Agencies typically screen and train caregivers, performing background checks and verifying references.