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Wisconsin Medicaid and BadgerCare Plus

What Has Changed or is New

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Please Note: The following information is about non-emergency medical transportation. If you have a medical emergency you should call 911.

Non-emergency medical transportation is a public transportation and shared ride service. Rides can include public transportation (such as a city bus), rides in specialized medical vehicles, or rides in other types of vehicles depending on your medical and transportation needs. If public transportation is not available, you will not be required to take it.

Medical Transportation Management, Inc. (MTM, Inc.), Wisconsin’s Medicaid and BadgerCare Plus transportation manager. MTM, Inc. schedules and pays for rides to Medicaid and BadgerCare Plus covered health care services.

Type of Rides

MTM, Inc. is required by federal law to use the least costly type of ride to get to your appointment, based on your medical and transportation needs.

If you have a car and are able to drive yourself to your appointment, but cannot afford to pay for gas, you may be eligible to be paid for mileage.

If you cannot ride a bus and you are not able to use your own car, a ride with the best type of vehicle based on your medical and transportation needs will be scheduled.

Rides may include a specialized medical vehicle or another type of vehicle. You may be required to share a ride with another rider during your trip to your appointment.

Bus Rides

  • You will be required to use the bus if :
  • You live within ˝ mile of a bus stop,
  • You are going to an appointment within 1/2 mile of a bus stop, and
  • You do not meet any of the exceptions listed below.
  • You will not be required to ride a bus if:
  • You do not live within ˝ mile of a bus stop,
  • There is not a bus stop within ˝ mile of your destination,
  • You are unable to ride a bus or get to a bus stop because of a physical or mental health condition (for example, if you are going to a dialysis appointment). You are a parent or caregiver traveling with a member age 4 or under to his or her appointment,
  • You are age 15 or under and are traveling alone, or
  • You are age 70 or older and use a walker, crutches and/or a cane.

Minors Traveling Alone

Members age 17 and under are minors. All rides for minors traveling to a covered appointment must be made by an adult. Minors usually need a parent or caretaker to go with them on their ride. The parent or caretaker is responsible for the minor for the whole trip and at the appointment.

If a parent or legal guardian signs a consent form, the following minors may travel without a parent or caretaker:

  • Minors age 16 – 17 years old when traveling by bus or a vehicle.
  • Minors age 12 – 15 years old when traveling by a vehicle only.
  • Minors age 4 – 11 years old when traveling by a vehicle only with at least one other child to the same day treatment program.

Rides to Veterans Medical Facilities

MTM, Inc. can schedule and pay for rides to a veterans facility for a Medicaid or BadgerCare Plus member who is a veteran, if the medical service could be covered by Medicaid or BadgerCare Plus.

Extra Stops

Extra stops will only be allowed for covered health care services, like an extra stop at the pharmacy to pick up a prescription or medical supplies on the way home from your appointment.

If you are getting a ride in a vehicle, all extra stops must be approved ahead of time. You can call MTM, Inc. while you are at your appointment and ask for any extra stops to be approved. The driver will not make any stops that are not approved.

Pharmacy and Disposable Medical Supplies

If you need to fill a prescription or pick up disposable medical supplies (DMS) after a covered appointment, you should try to do so on the way back from your appointment, if possible.

For example: If you need to pick up a prescription on your way home that your doctor prescribed you at your appointment, you will need to call MTM, Inc. to get approval for the stop before your ride comes to get you to take you home.

If you cannot fill your prescription or pick up your DMS after a scheduled appointment and the pharmacy is unable to mail you your prescription or DMS for free, a ride to fill your prescription or pick up your DMS can be scheduled.

All stops must be pre-approved. See “Extra Stops” above.

For more information

Information provided is general. For more information about Scheduling Rides, Meals and Lodging, Complaints, New Rules, Denied Transportation or Fair Hearings:

P-00533E (07/13)

Go Back to Non-Emergency Medical Transportation Home Page

 

Last Revised: August 16, 2013