Medicaid Transportation FAQ
A "Broker" is an agency under contract to the Washington Health Care Authority (HCA) to help Medicaid clients get transportation to healthcare appointments. Brokers like SMS determine if you are eligible for transportation and what type of transportation you need.
State and federal rules say that Brokers must choose the lowest-cost type of transportation that is appropriate for each trip. There are several types of transportation Brokers can chose from:
+ bus tickets or passes
+ gas vouchers
+ van (shared ride)
+ individual or group trip
Brokers try to use local transit whenever possible, as it is usually the least-costly transportation. If you feel you cannot ride the bus, you may be asked to submit a letter from your Primary Care Provider stating why you cannot use transit.
State and federal rules tell Brokers which Medicaid healthcare trips can and cannot be provided. Brokers may deny transportation requests for the following reasons:
+ You have requested a trip to a medical service that is not covered by your benefit services package.
+ You have requested a form of transportation that is not consistent with your needs and capabilities.
+ You have requested a ride to a healthcare provider outside your local community when there are comparable services available locally.
The Brokerage Call Center staff may be able to confirm your eligibility for Medicaid transportation in other ways. Please contact the Call Center to find out.
If you have a medical emergency, you should call 911. We are not able to provide emergency transportation.
You may be eligible for transportation to your medical appointments if you are a Washington State Medicaid client and you have no way to get to and from your healthcare appointments. We are only able to provide trips to medical services such as a doctor's appointment or dialysis, and the medical service must be covered under your Medicaid benefit services package. Please telephone our Call Center to see if you are eligible for transportation services. Our trained call center staff will gather some information from you and determine if you are eligible for the program.
Generally, any medical services that are paid for by your Medicaid program are eligible for transportation. There are some exceptions:
Transportation is available only to a "local medical provider of type." This means that if a qualified, local medical provider is available in your community, we cannot give you transportation to a provider in another community.
Some categories of Medicaid eligibility do not qualify, or only qualify partially, for transportation services. Our Call Center staff can talk to you about your specific situation.
The Health Care Authority (HCA) provides some transportation for clients under the state-funded Children's Health Program and the Medical Care Services program (MCS), formerly called Disability Lifeline. The MCS program does not provide transportation for mental health or substance abuse treatment services.
The Take Charge and Family Planning Only programs do not provide transportation.
Please contact our Call Center for more information about eligibility.
We will arrange transportation that meets any special transportation needs you may have and is the least costly means to get you to your medical appointment. This could include public bus, fuel voucher, volunteer driver, commercial or nonprofit provider (e.g. taxi, Dial-a-Ride van, etc.), cabulance, and intercity bus or train. Please be aware that you may be asked to share a ride with other passengers.
You have the freedom to choose whichever doctor you feel best provides your medical services. However, we can only transport you to a local doctor unless you have a document from a healthcare provider stating that you have a medical need to see a doctor outside your community.
If you plan to see a doctor outside your community, state rules require that these trips be approved in advance. Call Center staff will provide a referral form for your Primary Care Physician to complete for you. This completed form must be received by the Call Center at least two full business days in advance of your appointment to assure that transportation for you will be available.
Please remember, out of area trips may not be approved if a local healthcare provider is available in your community.
State and federal rules don't allow you to chose which type of transportation you get or which transportation company provides your trips. If you have a problem with the transportation company that provides your trips, please call us so that we can resolve the problem.
Please contact us as soon as possible. If the Call Center is closed, please leave a message so that we'll get it on the next business day.
You can schedule your return ride if you know about what time you will be done with your healthcare appointment. Your driver may arrive up to 30 minutes past your scheduled return time, although you will seldom need to wait that long. We suggest that you ask your driver for a card with the transportation company's number on it. If you have waited longer than 30 minutes for your ride home, call the transportation company directly or call SMS at 1-509-534-9760.
If you aren't sure when your appointment will end, then we will book your return ride as a "will call." When you arrive at your appointment, ask your driver for a card that has the transportation company's telephone number on it. When your appointment is finished, you or your doctor's office can call the transportation company for a ride home. Your driver has 60 minutes to arrive when called for a return ride, although you will seldom have to wait that long. Please do not call for a return ride before your appointment is finished. If you are not ready to go when the driver arrives, the driver will leave and you will be responsible for getting yourself home. If you have waited longer than 60 minutes for a "will call" return ride, please call your transportation provider directly or SMS at 1-509-534-9760.
Your transportation provider may ask you to be ready up to an hour before your appointment for local rides, or earlier for long-distance rides. This is because your driver may have to pick-up more than one person, must accommodate weather or traffic conditions, or needs extra time to ensure that your mobility device or other special equipment is properly secured for the trip.
You can reach the Call Center by telephoning (509) 534-9760 or toll free (800) 892-4817.
If you are hearing-impaired, please call (509) 534-8566 or toll free (800 821-7167. You may also dial 711 for the Washington Relay Service.
Our fax number is (509) 534-6980 or toll free (888) 829-9915.
Our Call Center is open Monday through Friday from 8:00 AM to 4:00 PM. It is closed on weekends and the following holidays :
● New Year's Day
● Martin Luther King, Jr. Day
● Presidents Day
● Memorial Day
● Independence Day
● Labor Day
● Veterans Day
● Thanksgiving Day (and day after Thanksgiving)
● Christmas Day
(Please note that observed holidays may fall on a different day from the actual holiday)
When the Call Center is closed, you can leave a message on our voice mail and our staff will call you back on the next business day. Sometimes you may find that you need to see a doctor and our Call Center is closed. We have an answering service that can help you with after-hours transportation needs. To reach the answering service, telephone our Call Center and our voice mail system will provide a link to the answering service.
You can request a ride up to a month in advance of your health care appointment, and we recommend that you contact us at least 7-14 days in advance.
When you make your ride request with less than two business days' notice and it is not urgent, you may be asked to reschedule your appointment if we can't find transportation for you.
If you usually receive bus passes from us for your transportation needs, please allow at least seven business days for us to process your request and mail your bus pass to you.
When you contact us for a ride to your Medicaid healthcare appointment, here is what you will need:
+ Your Medicaid Services card
+ Your complete pickup address
+ The time and date of your healthcare appointment
+ The address and phone number of the medical facility you will visit
+ The general reason for your appointment
+ Any special transportation needs you may have
+ Your return time, if known
Because of state and federal requirements, we must find the lowest-cost type of transportation that you are able to use for your healthcare appointments. Because people's transportation needs and abilities change, we need to be sure to keep up to date about your situation.
If you have recurring appointments, such as for dialysis, chemotherapy, or other ongoing healthcare needs, we will gladly arrange up to a month's appointments in one call. Or you can download and submit a ride request form (click here for ride request form).
We work with a variety of transportation providers in delivering Medicaid transportation. Providers include public transit systems, fuel voucher vendors, commercial providers such as taxi and cabulance, nonprofit organizations, intercity bus and train, etc.
In addition, we work with organizations that provide volunteer drivers and vehicles to transport Medicaid clients. We are always looking for organizations with experience providing community transportation services using volunteers. Please contact our Regional Manager at (509) 534-9760 or (800) 892-4817 if you think your organization would be interested in providing transportation for the Medicaid program.
We also directly manage a small number of volunteers who drive for the Medicaid transportation program and are reimbursed on a mileage basis. If you have an excellent driving record, a safe and reliable vehicle, and a desire to help, please contact us at (509) 534-9760 or (800) 892-4817.