Green Mountain Community Network, Inc. provides transportation to eligible medical appointments for individuals with the Medicaid and/or Dr. Dynasaur transportation benefit. If you, a family member or a patient you are working with needs local or long-distance transportation to a Medicaid covered medical appointment, contact us and we can assist you in determining your eligibility and provide a ride if eligible. If not eligible, there may be other programs we can offer to meet your transportation needs..
Rides are determined based on the most cost-effective, medically appropriate mode. Rides may be via public transportation bus, van, cab or volunteer driver and will be coordinated with other members and other programs whenever possible.
How Do I Know If I Qualify?
Medicaid will provide rides to Medicaid-billable or Blueprint-sponsored appointments for eligible members when it is determined that you have no other means of transportation available in your household. It must be proven by the member that no other transportation options exist.
3 Simple Steps to Determine Your Eligibility
- Call us toll free 877-530-6116 to confirm eligibility. Have your Medicaid ID number available when you call.
- We will conduct a DMV check, as required by Medicaid, prior to any transportation being scheduled. These checks can take up to 24-48 hours to be completed and are repeated on an annual and random basis to confirm eligibility,
- During your phone call, if eligible, we will intake your information and send a NEMT Rules and Guidelines form. This form must be signed and returned prior to your transportation benefits starting. The form can be sent to GMCN, Inc. 215 Pleasant Street, Bennington, VT 05201 or faxed to (802) 447-1868.
What If I Have a Vehicle in My Household and I Still Need Transportation?
If you or a family member owns a vehicle, but the vehicle is unavailable, you may still be eligible for a ride. The following reasons include:
- The vehicle is not registered with the DMV.
- There are no licensed drivers in the household per the DMV.
- The vehicle is not insured (policy cancellation documentation required).
- No one in the household is able to drive due to medical concerns (medical exception documentation must be provided by a physician).The vehicle is being used for work purposes and appointments cannot be scheduled around working hours (transportation employment verification form required).
If you meet the criteria above, you must complete and sign the Medicaid Vehicle Exemption Request form declaring the vehicles unavailable. The form will be reviewed by the Vermont Department of Health Access (Medicaid) for either approval or denial. We will notify you of the decision in 3-5 business days.
Easy Steps to Schedule a Trip
- To schedule a trip please contact us at toll free at 877 530-6116. Members should schedule their rides with at least 2 business days’ notice. Although not necessary, it is advised to schedule long distance trips with 5 days’ notice as the approval process sometimes takes longer. There are limited resources for transportation requests on short notice. We will do our best to accommodate last-minute requests (less than 48 hours) to the best of their ability unless no option is available due to late notice.
- Have your Medicaid ID number ready when you call.
- Have your doctor’s name, address and appointment time to give to the transportation provider.
- Your transportation provider will verify that both you and your doctor are Medicaid eligible and schedule your trip.
** In the event you are unable to keep your appointment you are required to call your transportation provider and cancel your ride. **
After three no-shows a member will be required to call in advance to confirm their ride the day before their scheduled appointment by noon. If the member does not call in, the driver will not be sent.
What Trips are Covered by NEMT Medicaid Transportation?
- Medical services that are recognized by the Vermont Medicaid Program as covered and billable medical services.
- The appointment can be verified by GMCN and its providers.
- The primary care physician’s office is the closest available to the member’s residence.
- Any trips over one hundred miles from your residence require a physician’s referral from your medical provider and authorization from Medicaid.
- Pharmacy trips are covered if the pharmacy does not have a mail or home delivery program and must be closest available to the member’s residence.
Out-of-State Facility Transports & Lodging
- A physician’s referral form must be submitted and preapproved by the Vermont Department of Health Access (Medicaid) for each out-of-area trip.
- Members will receive approval or denial in the form of a Notice of Decision. Once approved, contact us provider to confirm and schedule your trip. If you have been approved for lodging, VPTA will contact you to make arrangements your your lodging. VPTA must make all the lodging arrangements, with no exceptions unless prior approved by the Vermont Department of Health Access (Medicaid).
- Reimbursements will be paid for trip costs that have been pre-approved by the Vermont Department of Health Access (Medicaid).
- No reimbursements will be made without trip receipts.
- Reimbursement forms must be completed for each day of travel with all the day’s receipts attached.
- All forms must be signed and dated by the member and returned to their local transportation provider within 30 days of return home in order to be eligible for reimbursement.