MTM partners with medical facilities throughout Connecticut to ensure seamless, successful transportation delivery to HUSKY Health Medicaid members. Let us know how we can help you best arrange NEMT services for your patients.
Forms and Other Documents:
- Escort Approval Form
(for members aged 11 and under requiring facility escorts)
- Medical Necessity Form (you may hear this referred to as a Level of Need Form for higher transportation modes, or a Distance Verification Form for members going over the mileage limitations)
- Medical Necessity Form Instructions and Tips
- Mileage Reimbursement Trip Log
(for trips occurring on or after September 1, 2023)
- Minor Consent to Travel (for members between the ages of 12 and 15)
- Specialized Transportation Form (for out-of-state trips, including ambulance)
MTM Community Outreach
Frequently Asked Questions (FAQs)
NEMT is a limited transportation benefit that is provided to eligible Medicaid members in Connecticut. NEMT services are only available to HUSKY A, C, D, and limited benefit members who cannot drive themselves, and/or do not have a neighbor, friend, relative, or voluntary organization that can transport them to their appointment. The member must be attending a Medicaid-covered medical, behavioral health, or dental appointment.
NEMT requests must be scheduled at least two business days in advance. Urgent rides may be scheduled with less than the required days’ notice.
MTM’s customer service center is open from 7 a.m. to 6 p.m., Monday through Friday for scheduling routine appointments. Additionally, urgent requests are taken 24 hours a day, seven days a week. Please call 1-855-478-7350 to phone in transportation requests.
Medical facilities may also access the MTM Link Facility Portal to schedule and manage rides on behalf of patients. This tool replaces Veyo's Rideview portal. To sign up for an MTM Link account, click here to fill out a brief form. Our Community Outreach team will create your account and send you log in details.
Medical facilities may access the MTM Link Facility Portal to schedule and manage rides on behalf of patients. This tool replaces Veyo's Rideview portal. To sign up for an MTM Link account, click here to fill out a brief form. Our Community Outreach team will create your account and send you log in details.
An urgent trip is a situation in which there is no immediate threat to life or limb. However, the member must be seen on the day of the request. Treatment cannot be delayed until the next day.
Yes, MTM can schedule recurring trips, eliminating the need to schedule each trip individually. Recurring trips can be scheduled up to three months at a time.
Based on the member’s needs, MTM offers the following modes of transportation:
- Gas mileage reimbursement if the member, a friend, or family member can drive to the appointment.
- Fixed route bus tickets if the member’s home and destination are within ¾ (0.75) miles of a bus stop, and they can walk there independently and safely.
- Sedan, van, or taxi services if the member can walk between the door of their home/destination and the vehicle.
- Vehicle services equipped to transport standard sized and oversized wheelchairs if the member has specific mobility needs verified by their health care provider.
If a member says they are unable to utilize public transportation or gas mileage reimbursement, their health care provider will be required to fill out our Medical Necessity form. This form communicates the member’s actual needs to MTM for appropriate transportation mode assignment.
If the return time for an appointment is not known at the time of the reservation, MTM will assign the return trip as a will-call trip. In this case, you will call MTM when the member is ready for their ride home. MTM will dispatch the trip and the transportation provider will arrive within one hour. Call MTM at 1-855-478-7350 to find out the status of a transportation provider’s estimated arrival time.
If you or a member experiences an issue with NEMT, call MTM’s “We Care Line” at 1-866-436-0457 or fill out our convenient online form. We will follow up on all complaints and contact all parties involved in the scheduling and transport to resolve the issue.