Does Medi-Cal Cover Transportation to Medical Appointments?

Yes. Medi-Cal does cover transportation to medical appointments at no out-of-pocket cost when you have no other reasonable way to get there. The ride can be anything from a taxi or rideshare to a wheelchair van or non-emergency ambulance, depending on your medical needs, and the appointment itself has to be for a Medi-Cal covered service.¹

What Kind of Ride You Can Get

Medi-Cal splits transportation into three categories, and which one applies to you decides how much paperwork is involved.

Non-Medical Transportation (NMT) is a ride in a regular vehicle: a taxi, a rideshare, a bus pass, or your own car. It’s for members who can travel safely in a standard vehicle but have no other way to get to the appointment. You don’t need a doctor’s prescription. You do need to confirm to the transportation provider that no other ride is available to you.²

Non-Emergency Medical Transportation (NEMT) is a ride in a specialized vehicle such as a wheelchair van, stretcher van, or non-emergency ambulance. It’s for members whose condition prevents them from traveling in a regular car or on public transit. NEMT requires a written prescription from your doctor and prior authorization from your plan. Your doctor documents the medical need on a Physician Certification Statement (PCS) form, and your health plan itself has to review and approve that form.³

Emergency Medical Transportation is an ambulance for a medical emergency, usually dispatched through 911. No prior authorization is needed.

Covered destinations include medical appointments, dental visits, mental health and substance use disorder treatment, and trips to pick up prescriptions or medical equipment.¹

Who Qualifies

Two conditions must be met. First, the appointment has to be for a Medi-Cal covered service. Second, you must have no other reasonable way to get there, whether that’s your own car, public transit, or a ride from someone you know.²

Your plan has to authorize the least costly type of transportation that meets your medical needs. If a sedan is safe for you, you won’t be approved for a wheelchair van. If your condition requires a higher level of transport, the plan has to provide it. There is no cap on the number of trips as long as each one is for a covered service and medically appropriate.³

How to Book a Ride

The process depends on whether you’re in a Medi-Cal managed care plan or fee-for-service (FFS) Medi-Cal.

Managed Care Members

Call the member services number on your Medi-Cal health plan ID card. Many plans use a transportation broker to coordinate the ride. The Department of Health Care Services (DHCS) recommends scheduling at least five business days before your appointment. You can call sooner for urgent needs.⁴

Have ready: your Medi-Cal ID number, the provider’s name and address, and the appointment date and time. For NEMT, your doctor needs to complete the PCS form first. If you have recurring appointments, such as weekly dialysis, ask for a standing authorization so you don’t have to call each time. Plans must authorize recurring NEMT trips for up to 12 months at a time.³

If you’re approved for NEMT, the driver has to provide door-to-door assistance, not just drop you at the curb. That means help from your door to the vehicle and from the vehicle into the provider’s facility.³

Fee-for-Service Members

If you’re in FFS Medi-Cal rather than a managed care plan, you arrange transportation through DHCS directly. Submit your name and email through the online form on the DHCS transportation page, and staff will reply with a secure email containing a transportation request form. You can also contact NMT providers directly if you already have their information. For NEMT, tell your doctor about your transportation need first, then complete the same online request.¹

Driving Yourself and Getting Reimbursed

If you drive yourself to a Medi-Cal covered appointment, you can request mileage reimbursement. FFS members use the DHCS mileage reimbursement form, and the rate follows the IRS standard mileage rate, which is set annually.⁵ Managed care members should contact their plan’s member services department, since each plan handles the process differently.

The same basic rule applies: reimbursement is for members with no other way to get to the appointment, not for anyone who simply prefers to drive. Keep records of the appointment date, provider address, and round-trip distance.

Bringing Someone With You

Medi-Cal covers transportation for one attendant to ride with you when necessary. For NMT, a parent, guardian, or spouse can come along, subject to prior authorization when you first set up the request. For NEMT, the attendant’s transportation and related expenses such as meals and lodging on long-distance trips are also covered, and if the attendant is not a family member, Medi-Cal can even cover their pay.³

Mention the attendant when you schedule the ride so the authorization covers both of you. This matters most for children who need a parent present during treatment and for members with cognitive impairments who need a companion.

Trips to Distant or Out-of-Area Providers

Medi-Cal generally covers transportation to the nearest qualified provider who can deliver the service you need. If a closer provider can treat you, your plan can deny transportation to one farther away.⁶

There are exceptions. If you have an established relationship with a distant specialist and switching providers would harm your care, or if the distant provider has capabilities closer providers lack, your plan should cover the trip. The plan also cannot deny a ride to a farther provider when the cost difference is negligible. If your plan denies transportation to a specific provider, it should help you find a qualified alternative closer to home.⁶ For long-distance trips that require overnight travel, your plan must cover meals and lodging for both you and a necessary attendant.⁷

If Your Ride Is Late or Doesn’t Show

Managed care plans must get you to your appointment on time. If your ride doesn’t arrive, call your plan’s member services line immediately and ask for a replacement. Write down the date, time, and what happened. Plans have to meet timely access standards, and a pattern of late or missed pickups is something the plan is required to correct.⁸

If the problem keeps happening, file a grievance with your plan by phone or in writing. A grievance is a complaint about the quality of a service, which is different from an appeal of a denial. If your plan doesn’t resolve the issue, contact the Medi-Cal Managed Care Office of the Ombudsman at 1-888-452-8609.⁹

Appealing a Transportation Denial

If your plan denies a transportation request, it must send you a written Notice of Action with the reason. What you do next depends on your coverage type.

Managed Care Appeals

File an appeal with your plan within 60 days of the date on the Notice of Action. You can start the appeal by phone, but you’ll need to follow up with a signed written appeal. The plan has 30 days to decide. If the plan rules against you, or doesn’t respond within 30 days, request a state fair hearing. You have 120 days from the date on the plan’s written decision to do so.⁹

If waiting could harm your health, ask for an expedited appeal. The plan must decide an expedited appeal within 72 hours instead of 30 days.¹⁰ An expedited state fair hearing must be decided within three working days of the agency receiving the case file.¹¹

Fee-for-Service Appeals

FFS members skip the plan-level appeal and go straight to a state fair hearing. The deadline is 90 days from the date on the Notice of Action, with a possible late filing allowed for good cause such as illness or disability.¹²

The Medi-Cal Managed Care Office of the Ombudsman can help you work through either process. Call 1-888-452-8609 or email MMCDOmbudsmanOffice@dhcs.ca.gov.⁹

1
DHCS – CA.gov. Transportation Services
2
DHCS – CA.gov. Frequently Asked Questions for Medi-Cal Transportation Services
3
Department of Health Care Services. All Plan Letter 22-008
4
DHCS – CA.gov. Frequently Asked Questions for Medi-Cal Transportation Services
5
DHCS – CA.gov. FFS NMT Member Reimbursement Form Mileage
6
Centers for Medicare & Medicaid Services. Medicaid Transportation Coverage Guide
7
Medicaid.gov. Medicaid Transportation Coverage and Coordination Fact Sheet
8
Department of Health Care Services. APL 22-008 NEMT/NMT Services FAQs
9
Department of Health Care Services. Medi-Cal Help Center
10
DHCS – CA.gov. Grievances and Appeals
11
eCFR. Subpart E – Fair Hearings for Applicants and Beneficiaries
12
DHCS – CA.gov. Medi-Cal Fair Hearing