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Covered by Medicaid?  You Might Qualify for Free Transportation to Medical Appointments Through First Transit.

Saturday, 07 October 2017 10: 00
Written by Joni B. Bailey
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Did you know that if you have a Medicaid card and you do not have a way to get to your medical appointment you can get a free ride by signing up through NETSPAP, the Non-Emergency Transportation Services Prior Authorization Program?

What is NETSPAP?

The Illinois Department of Healthcare and Family Services (HFS) reimburses certain Medicaid participants for transportation to qualified non-emergency medical appointments.  In order to streamline this process and reduce waste, HFS created NETSPAP, the Non-Emergency Transportation Services Prior Authorization Program.

How do I sign up?

To participate in the program, Medicaid participants can submit a request for transportation to First Transit, Inc., an agency that HFS works with to manage medical transportation.

First Transit agents will decide if you qualify and work with you to arrange a car, van or bus to take you to and from the doctor’s office, clinic, or hospital when you have an appointment.

Your ride costs you nothing if it is approved by First Transit.  Participating transportation providers get paid for the trip by the Illinois Department of Healthcare and Family Services.

How do I know if I can get a free ride to see my doctor?

To qualify for the free transportation program:

  1. You must be covered by Medicaid on the day of your appointment.
  2. You must have no other way to get to your appointment.
  3. You must be going to a medical appointment (not shopping or to work).
  4. Your medical appointment has to be scheduled, or if you’re going for a walk-in visit, NETSPAP must be able to confirm they take walk-ins.
  5. You must be riding in the least expensive mode of transportation that meets your needs.
  6. You must be using a transportation company that is enrolled in the program and provides the mode of transportation that you need.
  7. You must be going to the closest medical provider that takes the Medicaid card.
  8. You must be going for a medical service that is covered by Medicaid.

How do I set up my ride to see my doctor?

Call First Transit at 877-725-0569. If this is your first time placing a request, they will make sure you qualify.

  • The operator will help you find the right ride for your needs. 
  • You will receive a list of eligible transportation providers.  
  • You will call and arrange for a ride with an eligible provider.
  • You will call First Transit again to confirm the trip and get approval.

After you have an account in the First Transit system, you can set up your free ride in four ways:

  1. By Fax – Fax your trip request form to (630) 873-1450.  Trip request forms can be obtained at NETSPAP.com.
  2. By Mail – Mail your trip request form to First Transit, Inc., 799 W. Roosevelt Road, Building 4, Suite 200, Glen Ellyn, IL 60137.
  3. If you have a preferred transportation company, you can ask them if they would be willing to request your transportation approval for you.
  4. Your doctor’s office might be willing to do it for you too. The First Transit phone number for all providers is (866) 503-9040.

What will they ask when I call First Transit to set up my account?

  • Your Medicaid ID number (9-digit Recipient Identification Number)
  • Your name 
  • Information on how you have been getting to your medical appointments before using this service
  • If there are medical or non-medical reasons why you cannot use public or other transportation
  • The date and time of the appointment
  • Your pick-up address and phone number
  • The address and phone number where you are going
  • The name of the office/clinic/hospital where you are going
  • The name of the doctor you will be seeing
  • The general reason for your doctor’s visit
  • If you use a walker, wheelchair, or cane
  • If you can travel by yourself or need an assistant
  • The name of your preferred transportation company

How far in advance of my appointment should I call First Transit?

Most trips can be approved or denied over the phone, but certain appointments, like those for physical therapy or behavioral health services, take longer to process.  To be sure that your request will be approved in time, it is best to call and make arrangements at least one week before your appointment.

If you can’t work because of your illness or injury…

Keeping your medical appointments and getting the treatment your doctors recommend will help you prove your Social Security Disability Insurance or Supplemental Security Income disability claim. 

Missing your medical appointments is a big mistake because that could make the judge think your condition is not very severe.  That could result in a denial of your claim.

Information for this article was sourced from NETSPAP.com.  For program information in Spanish, visit https://netspap.com/inicio/.

Joni Beth Bailey is a Southern Illinois disability attorney.


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