Medi-Cal Rides in California

If you're new to this, start with how rides to medical appointments work. This page covers California: Medi-Cal's two ride benefits, who to call, and what to do when a ride doesn't come.

If you no longer drive, getting to the doctor can be the hardest part. If you have Medi-Cal, your health plan must get you to covered care. Call the plan, and it books the ride. If you can sit in a car, you get a car, bus pass or rideshare. If you cannot, your provider fills out a form and you get a van.

You may qualify if

• You have full-scope Medi-Cal, though van rides are open to all Medi-Cal members.
• The ride is to care Medi-Cal covers, or to a Medicare doctor if you have both.
• You have no other way to get there. For example, you have no working car, you can't travel alone, or you can't pay for gas.

Not sure you qualify? Ask anyway, because your plan makes the call and it costs nothing to ask. If you would rather not do it alone, a Pair Team advocate can set up your rides with you in one call.

The two kinds of Medi-Cal rides

Who do I call to book a Medi-Cal ride?

To book a ride, call your Medi-Cal plan and ask for transportation. The member services number is on your plan card.

If you have Medicare and Medi-Cal, call your Medi-Cal plan, or your Medi-Medi Plan if you have one. See Medicare and Medi-Cal together.

If you have straight Medi-Cal

Straight Medi-Cal, also called fee-for-service, means you have Medi-Cal but no health plan.

• Car or bus ride (NMT): call a Medi-Cal ride company, or use the request button on the DHCS Transportation Services page. DHCS emails you a form.
• Van or ambulance (NEMT): tell your doctor, then send DHCS the same request. DHCS checks with your doctor first.
• Questions: you can email DHCSNMT@dhcs.ca.gov.

How far ahead should I book?

Book at least five business days before your appointment, if you can. Call as soon as you know, DHCS says. If you have repeat visits, ask for all of them at once.

What do I say when I call?

When you call, tell them:

1. The date, time and address of your appointment.
2. Whether you can sit in a car, or need a wheelchair van.
3. Why you have no other ride, if you want a car or bus ride.
4. If one person, such as your spouse, is coming with you.

How do I set up rides to dialysis?

To set up dialysis rides, ask your plan for a standing order. That's one request that covers every dialysis trip, so you don't call before each one. DHCS tells plans to approve rides for the whole length of your repeat visits, up to 12 months.

If you need a van, your doctor fills out the PCS form, and your dialysis center's social worker can help. Call your plan if your schedule changes or you go into the hospital.

What if my ride does not show up?

If your ride doesn't show, call your plan's ride line right away. Ride companies often ask you to call once the driver is 15 minutes late.

1. Ask the plan to send another ride, because DHCS rules say it must. For a car ride, the plan can instead let you book your own and pay you back.
2. Call your doctor or dialysis center to say you're running late.
3. Write down the date, the time and who you talked to, so you have a record.

How do I complain?

1. File a grievance (a complaint) with your plan, by phone or on its website, so the problem is on record.
2. If the plan says no to a ride, ask for an appeal within 60 days of the letter.
3. Call the Medi-Cal Managed Care Ombudsman for help at 1-888-452-8609, open 8 a.m. to 5 p.m., Monday to Friday.
4. Go to the state if there's no fix in 30 days, or you disagree with the answer. Call the Department of Managed Health Care's Help Center at 1-888-466-2219.
5. Ask for a State Hearing at 1-800-743-8525 if your appeal is denied, or if you have straight Medi-Cal.

What a Pair Team advocate does

People who call us about rides have often missed a visit already, and sometimes a refill or a form too. This is what we do:

• Call your plan with you to book rides and set up a standing order for dialysis.
• Get your doctor to send the PCS form when you need a van, and follow up until the plan has it.
• Call the plan when a ride does not show, and file the grievance with you if it keeps happening.
• Help with what usually comes with it: Medi-Cal paperwork, food, utilities and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Does Medi-Cal pay for Uber or Lyft?

Medi-Cal can pay for Uber or Lyft if your plan books a rideshare as your car ride.

Can a family member drive me and get paid for gas?

Yes, a family member can get paid for gas, with your plan's OK. Plans pay mileage when you set up the ride yourself in a private car. First, you tell the plan no other ride was available.

What if the plan says I can take the bus, but I can't?

If you can't take the bus, ask your doctor to fill out the PCS form for a van. Once your provider orders a type of ride, the plan cannot change it.

Do I need a new PCS form for every ride?

No, one PCS form can cover up to 12 months. Ask your doctor to send a new one before it runs out.

Does Medi-Cal pay for paratransit?

No, Medi-Cal does not pay for paratransit, which comes from your local transit agency. In Los Angeles County, apply to Access Services.

Sources

• Transportation Services, DHCS
• Frequently Asked Questions for Medi-Cal Transportation Services, DHCS
• All Plan Letter 22-008, DHCS
• Welfare and Institutions Code 14132, California Legislature
• MMCD Office of the Ombudsman, DHCS
• How to File a Complaint, DMHC
• Hearing Requests, CDSS
• Transportation Services for Medi-Cal Recipients, Disability Rights California