Does Medicaid Cover Transportation to Medical Appointments? (2026)

Yes, Medicaid covers transportation to medical appointments for members who have no other way to get there, because every state Medicaid program must assure rides to covered care.1 The benefit is called non-emergency medical transportation, or NEMT, and the Medicaid agency in each state decides how to deliver it: who books the ride, how much notice it needs, and whether a family member who drives you can be reimbursed for mileage.2 Booking rules, mileage rates and notice periods all come from your state, so the federal floor is only the starting point.3

In This Guide

• Who Qualifies for Medicaid Transportation
• Which Trips Medicaid Transportation Covers
• Ride Types, From a Bus Pass to a Stretcher Car
• How to Schedule a Medicaid Ride
• Family Drivers, Mileage, Meals, Lodging and Attendants
• What a Medicaid Ride Costs You
• Federal Standards for Medicaid Drivers
• When a Medicaid Ride Is Denied, Late or Missing
• If You Have Medicare and Medicaid
• Frequently Asked Questions
• Learn More

Who Qualifies for Medicaid Transportation

The transportation rule is narrower than "Medicaid gives everyone rides," and knowing its shape helps you ask for the right thing. In its transportation coverage guide, SMD 23-006, CMS says the assurance "is not a requirement for states to pay for a ride" but a requirement to make sure every Medicaid beneficiary "who has no other means of transportation has access to transportation needed to receive covered care." Before paying for a ride, the state is expected to look for free options first, such as a lift from family or friends. When several kinds of ride would work, CMS says the state must use the least costly mode that is appropriate for your physical and emotional condition.4

What counts as having no other means is partly up to your state. CMS's provider booklet on NEMT says states may require an unmet transportation need, and that depending on state law this can include not having a valid driver's license, not having a working vehicle in the household, being unable to travel or wait for services alone, or having a physical, cognitive, mental or developmental limitation. A state may generally expect you to use your own car when your circumstances allow it, though CMS recognizes that costs such as maintenance and fuel can stand in the way. States may add their own screening steps, as long as those steps are reasonable and don't restrict access.4

Distance has a rule too. Unless you have a medical need to see a provider farther away, CMS says the state generally must get you to the nearest qualified provider. CMS also protects your choice of provider: refusing a ride to the provider you picked, when that trip costs the same as a trip to a closer one or differs by only a trivial amount, could violate federal freedom-of-choice rules.4

If the no-other-means test rules you out, or you don't have Medicaid, our guides to senior transportation options and rides in rural areas with no bus service cover other ways to reach appointments.

Which Trips Medicaid Transportation Covers

The ride follows the coverage. CMS says states must ensure both emergency and non-emergency medical transportation where it's necessary for a beneficiary to receive covered services.1 States describe the destinations in their own words. The Texas Health and Human Services Commission (HHSC) lists trips to a doctor's office, dentist's office, hospital, drug store, or any place that provides covered health care services.5 TennCare says members can schedule rides to any TennCare-covered service, and the Georgia Department of Community Health defines NEMT as transportation to any Medicaid-reimbursable service.6,7

Because the assurance is tied to covered services, a dental trip works best when the dental visit itself is covered, so check whether your state's Medicaid covers adult dental care before booking. NEMT is also a scheduled-ride benefit rather than an emergency service: TennCare tells members to call 911 in an emergency.6

If you're in a home and community-based services (HCBS) waiver, you may also see a service called non-medical transportation, and it's a different thing. CMS says states have the option to cover non-medical transportation so HCBS participants can reach community services, activities and resources when other options are unavailable, for example under a 1915(c) waiver. CMS's 2018–2021 NEMT report to Congress describes it as offered in addition to medical transportation, not as a replacement, and treats an HCBS participant's rides to medical services as NEMT. Whether a particular waiver includes non-medical transportation is decided state by state and waiver by waiver.4 Our guide to HCBS waivers by state is a good place to start.

Ride Types, From a Bus Pass to a Stretcher Car

Federal rules describe Medicaid transportation by what it pays for, not by a fixed menu. The definition of travel expenses in 42 CFR 440.170 includes the cost of transportation by ambulance, taxicab, common carrier "or other appropriate means," and the same section lets a state's broker program cover wheelchair vans, taxis, stretcher cars, bus passes and tickets, and secured transportation.1 The Medicaid and CHIP Payment and Access Commission (MACPAC) adds that NEMT can include trips in personal vehicles belonging to you or to your family or friends.2

Which of these you get comes back to the least-costly rule: the state uses the least costly mode that is appropriate for your condition.4 Minnesota's Medicaid program, Medical Assistance, shows how that plays out. The state's Department of Human Services says a member who is able to use public transit must use it, with exceptions that include a walk of more than three-fourths of a mile, a professional determination that the bus isn't appropriate, or an assessment on file that rules transit out. Minnesota's agency then directly administers the higher levels of transport, which it lists as assisted, ramp or lift-equipped, protected and stretcher rides.6

Across the federal rules and these state examples, the ride types you're likely to see include:

• Bus passes or transit tickets, when you can manage public transit.6
• Mileage paid to you, or to a family member or friend, for driving a personal vehicle.2
• Taxis and vans.1
• Wheelchair vans and stretcher cars, for people whose condition calls for them.1
• Ambulance, which appears in the federal definition of travel expenses, though a state can draw the line differently: HHSC says the Texas NEMT benefit doesn't include ambulance transportation.5

How to Schedule a Medicaid Ride

Every state has to describe in its Medicaid plan the methods it uses to deliver rides, and federal law lets a state hand the job to a transportation broker selected through competitive bidding.1,3 States take very different approaches. The table below shows five different models, each described from the state's own materials, with notice rules given only as that state's example.

Georgia's model is covered step by step in our Georgia Medicaid NEMT guide.7 Maryland's row comes from a 2019 state health department report, the most recent departmental account we found, which also mentioned a broker pilot work group, so confirm the current setup with your local health department or Maryland's Medicaid program.8 Wyoming Medicaid also accepts requests online through its member portal.9

Texas splits booking by the kind of coverage you have. HHSC says members of a Medicaid managed care health plan arrange rides through the plan's medical transportation contact, while members outside managed care book through the state's own transportation program, and it asks for at least two workdays' notice, or five days for an appointment outside your county.5 Because notice rules like these differ from state to state, it pays to learn yours before the appointment rather than the morning of it.

Family Drivers, Mileage, Meals, Lodging and Attendants

Medicaid transportation isn't limited to vans and taxis. MACPAC reports that states pay for trips to and from medical appointments and reimburse enrollees or their friends and family for mileage on a personal vehicle. CMS's NEMT booklet lists family, friends and state-approved volunteers among the drivers a state can use, provided they're qualified under state law, and CMS's 2018–2021 report to Congress notes that states have promoted mileage reimbursement for family members, friends and volunteers who drive, particularly in rural areas. Neither MACPAC nor CMS's booklet sets a federal mileage rate, and the booklet stresses that every state's Medicaid program is different.2

Three states show the range. Health First Colorado says that if a friend, family member or caregiver drives you, you may qualify for mileage reimbursement, and that prior approval is required.10 Under its travel assistance guide effective July 1, 2026, Wyoming Medicaid reimburses an adult's personal-vehicle travel to out-of-town or out-of-state appointments at $0.26 a mile, measured as the shortest town-to-town distance, and doesn't pay mileage for local travel within the town where you live.9 In Texas, a member who has a car but no money for gas, or who wants a relative, friend or neighbor to drive, can be reimbursed after enrolling with the state as a personal-vehicle participant, and the member or the driver needs a current driver license, license plates, vehicle registration and car insurance.5

Federal rules also reach past the ride itself. The definition of travel expenses in 42 CFR 440.170(a)(3) includes meals and lodging on the way to and from medical care and while you're receiving it, plus the cost of an attendant to go with you if necessary, covering the attendant's own transportation, meals and lodging. The attendant's salary is included only if the attendant is not a member of your family.1 States set how far their own benefit goes. Wyoming's guide marks overnight lodging as not available to adults, and HHSC lists meals and lodging for Texans 20 and younger who stay overnight to get covered care.9,5

Bringing someone along generally turns on medical need in the states we reviewed. Health First Colorado says a parent, caregiver or other support person may be able to ride with you when medically necessary, and Georgia's NEMT definition covers an escort, if required.10,7 In Minnesota, if an adult member says they need an additional passenger who isn't their personal care assistant, the member's treating medical or mental health professional is asked to confirm that the passenger is medically necessary before the ride is scheduled.6

What a Medicaid Ride Costs You

What a ride costs you depends on how your state covers NEMT. A state can provide transportation as an administrative activity, as an optional medical service, or a combination of the two.1 In SMD 23-006, CMS says cost sharing is permitted for NEMT only if it's covered as an optional medical service, and "Cost sharing is not permitted for NEMT claimed as an administrative activity."4

Where a state does charge, CMS says the amount must be nominal and must follow the federal cost-sharing rules, including the groups that are exempt from cost sharing altogether. A provider can't deny you the ride because you can't pay, unless your family income is above 100% of the federal poverty level and you aren't in an exempt group. On top of that, Medicaid premiums and cost sharing for everyone in your household can't exceed 5% of family income, measured quarterly or monthly as your state specifies.4

MACPAC reports that some states require a nominal copayment to use NEMT, and whether your state charges, and how much, is set in its state plan.4 Georgia is one example where rides are provided at no cost to the member.7

Federal Standards for Medicaid Drivers

Since a 2021 change in federal law, every state must have a way to confirm that NEMT drivers meet a minimum floor. Under section 1902(a)(87) of federal Medicaid law, codified at 42 U.S.C. 1396a(a)(87), the state's check may include attestation, and it applies to any paid NEMT provider, including a transportation network company, and to each individual driver, though public transit authorities are excluded.11 At a minimum:

• Each provider and driver is not excluded from federal health care programs and is not on the HHS Office of Inspector General exclusion list.
• Each driver has a valid driver's license.
• Each provider has a process to address any violation of a state drug law.
• Each provider has a process to disclose each driver's driving history, including traffic violations, to the state Medicaid program.11

CMS says federal Medicaid law sets no additional basic driver and vehicle standards beyond these; those generally come from the state agencies that manage motor vehicles, and your state Medicaid agency may require more. CMS also says states must set qualifications and safety standards for drivers and use appropriate screening and credentialing.11

When a Medicaid Ride Is Denied, Late or Missing

Three different tools apply here, and they're easy to mix up: a complaint (in managed care, a grievance), an appeal to your health plan, and a state fair hearing. Which one fits depends on what went wrong and on who arranges your rides.

A late or missed ride

Start with the line that booked the ride. Georgia's broker, for example, keeps its call center open 24/7 for "Where's My Ride" calls and hospital discharges.7 If you're in a Medicaid managed care plan, you can also file a grievance with the plan at any time; the 60-day deadline described below applies to appeals, not grievances.12

A ride that's denied

If a Medicaid managed care plan denies a ride, the notice it sends is what federal rules call an adverse benefit determination. You have 60 calendar days from the date on a Medicaid managed care plan's denial notice to ask the plan for an appeal, and you can ask orally or in writing. If state law allows, a provider or an authorized representative can file for you with your written consent.12 If the plan upholds the denial, you can then request a state fair hearing. Your state sets the deadline to request a state fair hearing at 90 to 120 days after the managed care plan's appeal decision notice, and if the plan misses its own notice or timing requirements, you can go to a fair hearing without waiting.13

One wrinkle applies to transportation-only plans, which federal rules call non-emergency medical transportation prepaid ambulatory health plans (PAHPs): the plan-level appeal rules in 42 CFR 438 subpart F don't apply to them.12,14 Federal rules separately list enrollees in such a plan among the people the state must give an opportunity for a fair hearing.15

If your rides are arranged outside a health plan, the fair hearing is your route. Federal law gives you the right to a fair hearing before the state agency when a claim for medical assistance is denied or isn't acted on with reasonable promptness.15 A state can allow up to 90 days from the date its notice is mailed to request a Medicaid fair hearing, but it may set a shorter window, so go by the deadline printed on your own notice. Georgia's Medicaid hearing policy, for example, gives 30 days from notification of the decision to request a fair hearing.16

Keeping an existing service running during a managed care appeal runs on a much shorter clock. You generally have to ask for continued benefits within 10 calendar days of the plan's notice, or by the date the change takes effect if that's later.13 Our guides to Medicaid appeals and fair hearings and keeping coverage during an appeal walk through both steps.

If You Have Medicare and Medicaid

Under Original Medicare, Medicare Part B covers ground ambulance transportation when traveling in any other vehicle could endanger your health. In some cases it may also pay for a medically necessary, non-emergency ambulance trip if you have a written order from your doctor saying the ambulance is medically necessary; medicare.gov's example is someone with End-Stage Renal Disease who needs transport to and from dialysis. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Some Medicare Advantage plans may offer chronically ill enrollees a supplemental benefit that CMS calls transportation for non-medical needs, such as trips for grocery shopping or banking, but those benefits are plan-specific and not guaranteed, and they aren't rides to medical appointments.17 For the ride benefits a Medicare Advantage plan may offer and how to book them, see Medicare Advantage transportation benefits.

CMS's transportation guide notes that Medicare pays first for services both programs cover, but that "Medicare has a limited non-emergency ambulance transportation benefit." CMS's rule for full-benefit dual eligibles (people in the Qualified Medicare Beneficiary (QMB) Plus, Specified Low-Income Medicare Beneficiary (SLMB) Plus and Full Benefit Dual Eligible groups) has two parts. When you're going to a service Medicaid covers, even one Medicare pays for first, the state must ensure necessary transportation. When the service is covered by Medicare but not by Medicaid, covering the ride is the state's option; CMS's example is a trip to the pharmacy for Part D drugs, which federal law expressly excludes from Medicaid coverage. The Medicare Payment Advisory Commission (MedPAC) likewise lists transportation among the wraparound services Medicaid covers for people on both programs.4,3

If you're a partial-benefit dual eligible, the guidance is less direct. CMS's transportation guide states its rule for full-benefit duals, and CMS's NEMT report to Congress describes limited-benefit duals (in the QMB, SLMB, Qualified Disabled and Working Individual and Qualifying Individual groups) as eligible for Medicaid coverage of Medicare premiums or cost sharing only.4,18,3 If that describes you, ask your state Medicaid agency what transportation help applies in your case. For the Medicare side, see our guides to Medicare transportation coverage, ambulance coverage under Medicare and dual eligibility.

Learn More

Chat with Brevy's care navigator about setting up Medicaid rides to your appointments at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.