Medical transportation is available for NEMS members to travel to and from their appointments for services covered by their Medi-Cal or Medicare Advantage health plans. Transportation covers visits to medical, dental, mental health, or substance use disorder appointments, and to pick up prescriptions and medical supplies.
The two types of transportation are:
- Non-Emergency Medical Transportation (NEMT) by ambulance, wheelchair van, or litter van for those who cannot use public or private transportation
- Non-Medical Transportation (NMT) by car, taxi, or public transportation
For further assistance on how to schedule for transportation service, please call the NEMS MSO Care Coordination hotline at 415-352-5179, Monday to Friday, 8:30 a.m. to 5:30 p.m. This service is offered at no cost to all NEMS members.
Non-Emergency Medical Transportation (NEMT)
To request NEMT service, the member will need to meet all of the following criteria:
- Medical necessity
- Inability to use public transportation
All NEMT transportation services require a Physician Certification Statement (PCS) form completed by a treating clinician.
- For San Francisco Health Plan (SFHP), please contact the NEMS Utilization Management (UM) team. The transportation vendor will need to submit a Treatment Authorization Request (TAR) form along with a signed PCS form. The PCS form can be downloaded here. NEMS UM will review the submitted request based on medical necessity. When the NEMT service is approved, the transportation vendor will arrange the service directly with the member.
- For Anthem Blue Cross (ABC), please contact their customer service at 1-877-931-4755, Monday through Friday, 7:00 a.m. to 7:00 p.m., at least 5 business days prior to the appointment. Visit Anthem’s Transportation Services page to learn more: https://mss.anthem.com/california-medicaid/benefits/medi-cal-plan-benefits/transportation.html
- For Santa Clara Family Health Plan (SCFHP), please contact their customer service at 1-800-260-2055, Monday through Friday, 8:30 a.m. to 5:00 p.m., at least 5 business days prior to the appointment. Visit SCFHP’s Transportation Services page to learn more: https://www.scfhp.com/for-members/transportation-services/
Non-Medical Transportation (NMT)
NMT services are offered directly through the Medi-Cal managed care plans, which covers the lowest round trip cost of NMT services for the member and one attendant. To request for NMT service, the member will need to contact the health plan’s customer service.
- For San Francisco Health Plan (SFHP), please contact their customer service at 1-800-288-5555, Monday through Friday, 8:30 a.m. to 5:30 p.m., at least 5 business days prior to the appointment. Visit SFHP’s Member Handbook, Page 61-62, to learn more: https://www.sfhp.org/wp-content/files/programs/medi-cal/MC_Handbook_ENG.pdf
- For Anthem Blue Cross (ABC), please contact their customer service at 1-877-931-4755, Monday through Friday, 7:00 a.m. to 7:00 p.m., at least 5 business days prior to the appointment. Visit Anthem’s Transportation Services page to learn more: https://mss.anthem.com/california-medicaid/benefits/medi-cal-plan-benefits/transportation.html
- For Santa Clara Family Health Plan (SCFHP), please contact their customer service at 1-800-260-2055, Monday through Friday, 8:30 a.m. to 5:00 p.m., at least 5 business days prior to the appointment. Visit SCFHP’s Transportation Services page to learn more: https://www.scfhp.com/for-members/transportation-services/
NEMS members who are enrolled into the Health Net Medicare Advantage plan may receive both NEMT and NMT services through Health Net’s contracted agency, Access2Care. Members may refer to the chart below to schedule for transportation services or contact the NEMS Care Coordination team for further assistance.