Long-distance trip requirements vary for each health plan. Questions can be directed to our Member Service Center to speak with a representative.

• Minimum two full business days, Monday through Friday, is required to request a routine appointment.
• Minimum five full business days, Monday through Friday, is required to request a long-distance trip.
• Our agents will refer to the members benefit plan for guidance on short notice requests.

Please be advised the assigned transportation provider will call you 24 hours in advance of your appointment to confirm the pickup time for your appointment. Please be ready at least 90 minutes prior to your scheduled appointment time. The provider is required to drop you off at least 15 minutes but no more than 60 minutes prior to your scheduled appointment time.  If your trip is assigned to a Transportation Network Company, like Lyft or Uber, you will not be contacted 24 hours in advance.

There is no minimum age requirement if a member is seeking family planning/pregnancy related services or behavioral health services.

If the Member is 14 years of age or younger, the member must be accompanied by a parent, guardian, or another adult authorized in writing by the parent or guardian on a form prescribed by the state of Texas.

If the member is 15 to 17 years of age, the member must be accompanied by a parent, guardian, or another adult authorized by the parent or guardian unless the member presents the parent's or legal guardian's signed, written consent for NEMT services to Access2Care.

Emancipated minors can travel alone if the appropriate emancipation paperwork is on file with Access2Care.

Please call your health plan's toll-free number to schedule your trip. The Access2Care Care Coordination Team will assist in providing you with the required documentation. Please note that all required documentation must be returned to Access2Care no less than one day prior to the trip occurring.

• For Members birth through age 20, the Managed Care Organization must authorize advanced funds to be used to purchase gas, meals, or lodging prior to the trip, if the Member requires these funds in advance to access necessary Health Care Services. The costs are either:
  • Directly associated with a long-distance trip to obtain health care services; or
  • Necessary because a member who is already outside his or her county of residence experiences an unplanned or urgent healthcare event that requires the member to remain in the area overnight for treatment before the member can return home.
• Advanced funds are intended to cover NEMT services such as meals, lodging, and mileage reimbursement. The health plan may authorize advanced funds in additional situations such as airline tickets, taxicab, commercial bus tickets, toll charges, and parking fees if the health plan determines it is in the best interest of the member or if providing advanced funds is more cost-effective than other NEMT services.

MEALS AUTHORIZATION GUIDELINES

• A $25 dollar meal per diem for the member and single attendant is allowed.
• Additional attendants are also eligible for the meal per diem when a health care provider documents the need for such attendant. The member and/or health plan is responsible for providing Access2Care with the documentation from the health care provider for this request.

LODGING AUTHORIZATION GUIDELINES

• The health plan may approve lodging requests the night before a covered service if:
  • Travel cannot be reasonably accomplished on the day of the appointment.
  • A health care provider's statement of need or equivalent documents the necessity to travel the night before.
• The health plan may authorize lodging requests the night after a covered service if:
  • Travel to the member's residence qualifies for discounted airfare.
  • Travel to the member's residence reasonably requires an additional day due to length or circumstances beyond the member's control.
  • A health care provider's statement of need or equivalent documents the necessity for additional lodging.
• Lodging reimbursement will be calculated using the Texas Comptroller of Public Accounts.
• Lodging reimbursement is limited to the overnight stay and shall not include any amenities or incidental charges incurred during the member's stay (i.e., phone call, room service, laundry, etc.).
• Access2Care must authorize lodging for an attendant when a health care provider documents the need.

Members may travel to any Medicaid-enrolled location within their service delivery area. When traveling outside of your health plan’s service delivery area, or if the requested trip exceeds the specified mileage determined by your health plan, prior approval will be required by your health plan to approve the long-distance travel. As such, any long-distance trip requests must be made no less than five business days in advance.

INDIVIDUAL TRANSPORTATION PARTICIPANT (ITP)

The ITP program allows a member to drive themself or have a friend or family member drive them to medical appointments and receive mileage reimbursement. The mileage calculation is based on the shortest distance determined by a nationally recognized geocoding system. The mileage reimbursement rate is based on the rate established by the state of Texas.

HOW TO BECOME A REGISTERED ITP DRIVER

If you are interested in utilizing mileage reimbursement for yourself or a family member or friend, you must first register as an ITP driver with Access2Care. Your application packet must be fully processed by Access2Care prior to scheduling a mileage reimbursement trip.

HOW TO REQUEST REIMBURSEMENT FOR A SCHEDULED TRIP

Once you have registered as an ITP driver with Access2Care, you can schedule mileage reimbursement trips. Please note that the two full business days requirement for routine appointments is not applied for mileage reimbursement trips; however, the trip must be scheduled with Access2Care prior to the appointment occurring. Some health plans may require additional notice if the trip is long distance. Access2Care must receive the completed trip log within 95 calendar days from the appointment date to be eligible for reimbursement. Once received, mileage reimbursement will be processed and issued within 30 calendar days from the date of receipt. A signature from a representative at the medical facility and the ITP signature is required on the trip log. 

SUBMIT A COMPLETED ITP PACKET WITH REQUIRED DOCUMENTS TO ACCESS2CARE:

• Submit ITP Trip Log Electronically: ITP Trip Log (English)  |  ITP Trip Log (Spanish)
• Download a copy of the Trip Log: ITP Trip Log (English)  |  ITP Trip Log (Spanish)
• ITP Submission Portal: ITP Submission Portal
• Download a copy of the ITP Packet: ITP Packet

The state of Texas requires that Medicaid NEMT transportation be delivered by public transit fixed route bus and light rail services when available and appropriate for travel between the member’s residence and appointment. Members using public transportation have flexibility when traveling to and from their medical appointments, the services are dependable, and routes are designed to hit key areas of their community including medical facilities. In addition, bus passes may be used for additional travel needs until it expires!

Public transportation may not be suited for everyone. Members with physical or cognitive impairments may request a travel assessment to determine whether a more advanced level of service is appropriate. Members can be granted a 14 day waiver allowing the use of their requested level of service while Access2Care coordinates with their healthcare provider to determine the most appropriate level of service.

Paratransit & Specialty Services

In some areas of the state, Access2Care has enhanced public transit partnerships allowing use of their services beyond fixed route. If preferred, members eligible with their local public transit system to use specialty services, like paratransit, are welcome to contact us to see if specialty transit passes are available for travel to medical appointments. These partnerships help support local transit programs and provides more travel options within our NEMT program to best serve members.

Contact the appropriate toll-free number based on the member’s health plan benefits when you are ready to return home and a driver will be dispatched to arrive within 60 minutes. Agents are available 24/7 to answer your call. Additionally, members can contact the transportation provider directly to request their return ride.

Managed Care Organizations	Toll-Free Numbers
Aetna TX	866.411.8920
Amerigroup TX MMP	844.869.2767
Amerigroup TX Star	833.721.8184
Amerigroup TX Star Kids	844.864.2443
Amerigroup TX Star+Plus	844.867.2837
Baylor Scott & White/Right Care	877.447.3101
Community Health Choice D-SNP	844.683.6449
Community Health Choice Star	844.572.8194
Cook Children's	844.572.8195
Dell Children's Health Plan	844.867.2742
El Paso Health	844.572.8196
First Care	833.779.3105
Molina Healthcare of Texas Medicaid	866.462.4857
Molina Healthcare of Texas MMP	866.462.4856
Parkland Community	833.931.3844