Non-emergency Medical Transportation, or more known as NEMT, is a fundamental service that assists people who have difficulty getting to and from medical appointments. In 1974, the Smith v. Vowell District Court Case was monumental in obligating states to fund transportation for Medicaid patients. This ensured that transportation is/was provided to receive the health care access necessary. Whether it is due to mobility issues or a lack of transportation, this offering can be a lifesaver to many individuals who seek professional healthcare.  

What is NEMT? It is a mobility service for medical transportation provided for medical appointments (regular visits and treatments) not an emergency medical service (EMS) or ambulance. These are typically scheduled or routine appointments and extend to adult day services.  

Who Funds NEMT Services

A various funding pool supports NEMT services. These can range from private pay to federal funding:

• Medicare: A federally funded health insurance program that covers its beneficiaries with transportation to and from a medical appointment. ‍
• Medicaid: Joint federal and state program that subsidizes medical costs for people with limited income and resources.  ‍
• State health departments: Funded through state and federal resources, these departments assist more specific groups like individuals with disabilities or low-income families.  ‍
• County/Municipal government programs: These programs are typically funded through local taxes or grants for residents of those specific areas. ‍
• VA Programs: The Department of Veterans Affairs (VA) provide funding through different programs like: Veterans Health Administration (VHA) Community Transportation, Medical Transportation Program (MTP), Grand and Per Diem (GPD), and Adaptive Equipment and Transportation (A&T).  ‍
• Grants: The funding for grants can come from various institutions, federal and state agencies, and local governments. Also, private foundations, non-profit organizations, community development initiatives, health care providers & hospitals, and charitable organizations are also among the many who help to provide financial assistance. ‍
• Private insurance: Some private insurance companies offer to cover NEMT as a medical benefit, but the extent of coverage varies between providers depending on the specific policy. ‍
• Private Pay: In rare cases, NEMT services may not be covered for some patients, and they will have to pay out of pocket for transportation.

Transportation Types of NEMT Services

There are several distinct types of NEMT transportation services, depending on specific needs. These include:  

• Transportation providers: There are specialized transportation providers dedicated to the NEMT industry and some who cater specific vehicles to patients' needs such as wheelchair and stretcher accessible transportation. The drivers of these vehicles are guaranteed to be qualified and licensed to cater to the patients’ specialized needs through best practices.  
• Taxi or ride-sharing services: These are the easiest to access and the most basic type of NEMT typically targeted for ambulatory patients. They can be booked through a smartphone app or by calling the company directly to book a trip.  
• Public transport: Many states and cities have public transit options that people can take to and from medical appointments. These can include buses, trains, and subways and are suitable for ambulatory and wheelchair patients in most locations.  
• Paratransit: Paratransit is a type of NEMT service made for people with disabilities unable to use regular public transit. This can include specialized buses or vans with wheelchair ramps.  ‍
• Volunteer driver programs: A lesser-known type is utilizing volunteer driver programs that some communities have, to transport patients with medical appointments. These drivers are volunteers who provide transportation and are organized by religious groups or community organizations.  ‍
• Private pay: An unfunded NEMT service includes private pay that is out of pocket through private pay options. These include renting a car, hiring a personal driver, or taking a ride-sharing service (ex. public transport).  

Eligibility for these services is through state Medicaid funded or other insurance programs. One of the most important things to consider as to why NEMT is a vital component for health care is the challenge for many people to get to and from appointments, especially the individuals who live in rural or remote areas.  

Non-emergency Medical Transportation (NEMT) is a growing service as more people are proactively taking control of their health to get to necessary medical appointments by providing access to transportation. When individuals have difficulty getting to medical appointments, it can delay receiving the proper healthcare attention and potentially lead to poorer overall health. Mobility is a social determinant of health, which in return, allows individuals to get to the necessary health visits. Also, often NEMT services are used as transportation for adult day facilities that are not being transported to medical appointments, but to see friends or attend activities. NEMT services reduce healthcare costs by being proactive and preventing emergency room visits and longer hospitalizations by ensuring that all individuals have access to healthcare.  

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