Chapter 16: Medical Transportation Procedures

This chapter contains:

• EmblemHealth’s policies related to covered emergency transportation, and medically necessary nonemergency transportation services to and from health care appointments for Medicaid, HARP, and Medicare HMO Dual Eligible Special Needs Plan (D-SNP) members covered by Medicaid fee-for-service (FFS).
• Information on how to access services through the New York State Department of Health transportation vendor in counties where transportation services are covered by Medicaid FFS.
• Transportation for City of New York Medicare members with end-stage renal disease.

Emergency Transportation
In the event of a medical emergency, EmblemHealth covers emergency transportation to the nearest appropriate facility for Commercial and Medicare members. Medicaid FFS covers emergency medical transportation for Medicare HMO D-SNP, Medicaid, and HARP. Emergency transportation does not require a preauthorization. Members are instructed to dial 911 to obtain immediate assistance.

Routine Transportation
Medicaid FFS covers medically necessary nonemergency transportation for Medicaid, HARP, and Medicare HMO D-SNP members to obtain medical care and services. Nonemergency medical transportation includes: personal vehicle, bus, taxi, ambulette, and public transportation.

To arrange for transportation, members/providers must call the New York State Department of Health (NYSDOH) Medicaid Transportation Manager in the member’s County.

*Note: Undocumented non-citizens who are age 65 and older enrolled in Medicaid do not have coverage for nonemergency transportation services through Medicaid FFS or EmblemHealth.  

If possible, the member or provider should contact NYSDOH at least 3 days prior to the member’s medical appointment and give the representative:

• Medicaid ID number (for example, AB12345C).
• Appointment date and time.
• Address where the appointment will take place.
• The doctor’s name.

For more information visit the eMedNY website.

City of New York Medicare Members with End-Stage Renal Disease
In 2020, transportation for City of New York Medicare members receiving dialysis may use Coordinated Transportation Solutions if transportation assistance is needed.