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  • Medical Transportation Procedures > Personal Vehicle Mileage

    TABLE 1
    PERSONAL VEHICLE (MILEAGE)
    Service Area Medicaid Medicaid Advantage HMO Dual Eligible (HMO SNP) MAP-MLTC & MLTC Dual Eligible HMO/PPO SNP

    New York City

    Not Covered

    Not Covered

    Not Covered

    Not Covered

    Nassau

    Covered by Medicaid FFS

    Covered by Medicaid FFS

    Not Covered

    Covered by Medicaid FFS if member has benefit

    Rockland

    N/A

    N/A

    N/A

    HMO SNP - N/A

    PPO SNP - Covered by Medicaid FFS if member has benefit

    Suffolk

    Covered by Medicaid FFS

    Covered by Medicaid FFS

    Not Covered

    Covered by Medicaid FFS if member has benefit

    Westchester

    Covered by Medicaid FFS

    Not Covered

    Not Covered

    Covered by Medicaid FFS if member has benefit

    Criteria: When covered by Medicaid FFS, personal vehicle can be used to drive to any medical appointment or service.

    Prior Approval: Required.

    Who Arranges Services: Members call the LDSS' vendor to register.

    Member Reimbursement: Contact the LDSS' vendor for reimbursement.

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    Glossary terms found on this page:

    An organization that provides comprehensive health care coverage to its members through a network of doctors, hospitals and other health care providers. Also called a Health Maintenance Organization.

    A city or county social services district as constituted by Section 61 of the New York State Social Services Law (SSL). Also called a Local Department of Social Services.

    Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.

    A jointly funded federal and state program that provides hospital and medical coverage to the low-income population and certain aged and disabled individuals.

    An individual and each of his or her eligible dependents, including Medicare beneficiaries who are enrolled or participate in a benefit program and who are entitled to receive covered services from the practitioner pursuant to such benefit program and the terms of the practitioner's agreement.

    A health plan that offers benefits in-network and out-of-network. In-network services are available to enrollees at lower out-of-pocket cost than the services of non-network providers. In addition, PPO enrollees may self-refer to any network provider at any time. Also called a Preferred Provider Organization.

    The process of obtaining advanced approval of coverage for a health care service or medication. The request for services is reviewed to assess medical necessity and appropriateness of elective hospital admissions and non-emergency outpatient services before the services are provided. Also called pre-authorization or pre-certification or pre-determination.

    The geographic area in which a health plan is prepared to deliver health care through a contracted network of participating providers.

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