skip navigation Smaller text size Reset text size Larger text size
Families & Children Women Teens Adults Seniors People with Disabilities
DHHS Home > Office of Medicaid & Business Policy >
Non-Emergency Transportation Program for Medicaid Recipients in Fee-for-Service Program

Please use NH Medicaid’s Non-Emergency Transportation Program if you need a ride to, or help paying for gasoline to travel to, a Medicaid-covered service.

NH Medicaid recipients who are in the state’s Fee-for-Service program get their transportation through One Call. Medicaid recipients in one of the Managed Care Organizations should call their Plan’s transportation phone number listed in the Non-Emergency Medical Transportation Quick Summary Guide Adobe Acrobat Reader Symbol.

One Call will arrange your ride using public transportation where available, a transportation service, a wheelchair van, or non-emergency ambulance service if medically necessary. Have your Medicaid ID number and appointment information on hand. Your Medicaid ID number is listed on your blue NH Medicaid ID card.

How do I get reimbursed for mileage to NH Medicaid Services?

Enroll in the Family and Friends Mileage Reimbursement Program: You will be paid for your mileage from your home to your Medicaid-covered service and back to your home. If you are unable to drive yourself, family and friends can enroll in the program and you will be paid for mileage to Medicaid-covered services. You must call the transportation vendor in advance of the trip if you want to be reimbursed for mileage. If you are enrolled in Family and Friends Mileage Reimbursement Program, you need to complete a Medicaid Transportation Reimbursement Form for each approved trip.

Medicaid Transportation Reimbursement Form for Fee-for-Service Recipients Medicaid Fee-for-Service program recipients are reimbursed by One Call for covered trips made by friends and family members at a per mile rate of $ .41 when you complete the Medicaid Transportation Reimbursement Form and are approved for reimbursement. Forms are available from One Call at 1-833-303-0653 (TDD: 7-1-1 or 1-800-735-2964). Forms for standing orders and multiple trips to the same Medicaid-covered service are pre-populated and mailed to you when you contact One Call for approval. For one trip to one Medicaid-covered service, you can use the Single Trip Reimbursement Form Adobe Acrobat Reader Symbol or have a form mailed to you when you contact One Call for approval.

Using the instructions printed on the vendor’s Medicaid Transportation Reimbursement Form, complete the form, and bring it to your medical appointment for the provider to complete. You then need to mail, scan and email, or fax the completed form to the vendor as specified on the form.

Please call at least 48 hours in advance to request a ride. Have your Medicaid ID number, which is on your blue Medicaid card, and appointment information available when you call One Call.

 

Adobe Acrobat Reader Symbol Adobe Acrobat Reader format. You can download a free reader from Adobe.


 
Translate this page

Disclaimer

New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852


copyright 2016. State of New Hampshire