Idaho Members

We arrange rides for eligible Idaho Medicaid members. Call us to set up rides to your Medicaid appointments if you have no other way to get there. You must be attending a covered Medicaid service. We work with a network of transportation providers to help meet your transportation needs.

To schedule a ride, call us at 1-877-503-1261. You must call at least two business days before your appointment. If you call with less notice and the trip is not urgent, we may not be able to set up your ride. We schedule rides 24 hours a day, seven days per week. You can also use the MTM Link web portal and mobile app to book your trip at any time.

Please have the following information ready when you call:

• Your first and last name
• Your Medicaid ID number
• Your home address and phone number
• Your healthcare provider’s name, phone number, fax number, and address
• The date and time of your appointment
• Any special accommodations, including if you need a specific vehicle type, an attendant, or travel with a service animal
• General reason for the appointment; for example, check-up, dentist, counseling, physical therapy, etc.
• If you require special equipment like a car seat, wheelchair, or other device, you must inform MTM, then provide these items at time of pick-up

You may schedule more than one ride at a time if you have multiple upcoming appointments.

You will receive the level of transportation that is most appropriate for your medical condition. We may consult your health care provider. Based on your needs, we will offer you one of the following modes of transportation:

• Gas mileage reimbursement (GMR) is available to you if you can drive yourself to your appointment, or available to a friend/family member who can drive you. Refer to the section of the Member Handbook titled Will You Reimburse Me for Making My Own Transportation or Lodging Arrangements? for additional details. The Handbook is located under the Forms and Other Documents section of this website.
• Fixed route public transportation is available to you if your home and destination are within ½ mile of a bus stop, and you can walk there independently and safely. Public transit is also available to any member who specifically requests it, regardless of travel length to a stop.
• Passenger vehicles are available to you if you can walk between the door of your home/destination and the vehicle. This may include taxi services.
• On-demand transportation services like Uber or Lyft are available to select members who opt-in to using these services as follows:
  • Members must be age 18 or over; minors under the age of 18 may not ride alone with Uber or Lyft, even with a Parental Consent Form on file
  • Members must be ambulatory
  • Members with an intellectual or developmental disability must have a companion ride with them when using Uber or Lyft
  • On-demand services are not available in all areas or at all times of the day. When using on-demand services, the experience may be slightly different from when you use a traditional transportation contracted with MTM. This may include:
    • Your driver will not try to contact you if you aren’t at the pick-up location
    • Your driver will not wait 15 minutes for you to arrive at the pick-up location
    • Your driver will not help you enter or exit the vehicle
    • Your driver will not help you buckle your seatbelt
• Wheelchair-equipped vehicles are available to you if you utilize a mobility device and cannot transfer into a sedan vehicle. This level of transportation requires a Level of Need (LON) form on file from your health care provider.
• Stretcher vans are available to you if you are confined to a bed and cannot transfer to a wheelchair. This level of transportation requires a Level of Need (LON) form on file from your health care provider.
• Ancillary services are available for appointments that require you to travel a long distance to see your healthcare provider. This may include air transport, ground transportation from the airport, reimbursement for meals and lodging, and attendant services. Refer to the section of the Member Handbook titled Will You Reimburse Me for Making My Own Transportation or Lodging Arrangements? for additional details. The Handbook is located under the Forms and Other Documents section of this website.

Call MTM Health at 1-877-503-1261 to schedule an urgent ride. You can call for an urgent ride 24 hours a day, seven days a week. Urgent rides include those for:

• Urgent care services
• Hospital/facility inpatient and outpatient discharges
• Emergency room discharges
• Will call or return rides

Urgent rides will be provided in one hour or less. We do not give rides for emergencies. Call 911. You may also schedule non-urgent rides after regular business hours using our MTM Health web portal or mobile app.

If you don’t know the end time of your appointment when you make your initial ride request, we will schedule your return ride as a will call. Once your visit is over, call MTM Health at 1-877-503-1261. Your driver should arrive within one hour.

Yes. A recurring trip is when you need rides to appointments with sequential dates and times on a daily, weekly, or bi-weekly basis for an extended period. You may schedule recurring trips for up to six months at a time.

Yes. Please call us at 1-877-503-1261 when you are ready for your ride home after being discharged from the hospital. Your driver should arrive within one hour.

No. We do not provide emergency transportation. If your condition is severe, call 911 or go to the closest emergency facility right away. If you are not sure if it is an emergency, call your doctor. Your doctor will tell you what to do.

Emergency services are what you get when you are very ill or injured. These services try to keep you alive or to keep you from getting worse. You have an emergency when you need immediate attention to stop bleeding, relieve severe pain, or save a tooth. Some examples are:

• Broken bones
• Abscess
• Bleeding that will not stop
• You are pregnant, in labor and/or bleeding
• Trouble breathing
• Chest pains
• Suddenly unable to see, move, or talk

Yes. Urgent care is not emergency care. Urgent care is needed when you have an injury or illness that must be treated within 48 hours. Your health or life are not usually in danger, but you cannot wait to see your doctor or it is after your doctor’s office has closed. Please call 1-877-503-1261 to inquire about scheduling a short notice trip for urgent care.

When you call, please tell us if you would like to ride with a certain provider. MTM Health will make every effort to accommodate your request. However, we cannot guarantee your provider of choice. MTM Health has a directory of contracted transportation providers available under the Forms and Other Documents heading on this web page.

On the day of your ride:

• Your driver may arrive up to one hour before your scheduled appointment time, depending on length of travel.
• Be ready for your ride at least 15 minutes prior to the scheduled pick-up time. The driver will only wait for you for 15 minutes after the scheduled pick-up time.
• If you scheduled a ride back, your driver should pick you up less than 15 minutes after your visit is over. Call MTM Health at 1-877-503-1261 if your driver is late or does not pick you up.
• If your visit is over and you did not schedule a ride back, call MTM Health at 1-877-503-1261. The driver should arrive in less than one hour. Call MTM Health back if you have waited longer.

Call MTM Health at 1-877-503-1261 if you have waited:

• More than 15 minutes after your scheduled pick-up time
• More than one hour after calling MTM Health to schedule a return ride, if a return ride was not scheduled during the original request

Call MTM Health at 1-877-503-1261 if you need to cancel your ride or make any changes.

If a child is aged 14 to 17 years old and needs to ride without a parent or guardian present, the parent or guardian must fill out a Parental Consent Form. This form is located under the Forms and Other Documents section of this web page. This form allows MTM Health to give rides to a child/children without an adult riding along. The child’s parent or guardian must fill out, sign, and send MTM Health the Parental Consent Form before we can set up rides for a child/children to ride alone.

To help ensure their safety, children under 14 must ride with a parent, a guardian, or an adult attendant. If the parent or guardian of a child under 14 would like their child to be allowed to ride alone, they can contact MTM Health and make an exemption request when scheduling the ride. MTM Health will send the request to the Idaho Department of Health and Welfare for review and consideration. Each request will be reviewed on an individual basis, and not all requests will be granted.

Yes. Long-distance transportation services are available when medically necessary. A long distance trip is a trip that requires you to travel a far distance to see your healthcare provider. You must request these trips at least 10 calendar days in advance. Depending on the distance of your trip, you may need a Distance Verification Form on file before the date of the trip. This form is located under the Forms and Other Documents heading on this web page. The Distance Verification Form validates your need to travel to access medically necessary services. Your referring healthcare provider must complete this form and return it to MTM Health before transportation services can be prior authorized and arranged.

We recommend you call at least 14 business days before your appointment. When you call, please be ready to provide the date and time of your appointment and your doctor’s contact information. We will notify you when the trip is approved. If the trip is urgent, we will verify urgency with your healthcare provider.

You must also make requests for assistance with other long-distance services when you call. This may include air transport, ground transportation from the airport, attendant services, reimbursement for meals, and lodging requests. 

Idaho’s Medicaid NEMT program allows you to request reimbursement for specific services. Reimbursable services are intended to help eligible members travel to and from their medical appointments, and include:

• Gas mileage reimbursement
• Meals
• Lodging
• Ground transportation
• Attendant service

To receive reimbursement for these services, you must request the service through MTM Health and receive approval before the date of travel.

Reimbursement is made through a reloadable debit card issued by US Bank. If you don’t yet have a card when you request reimbursable services, an MTM Health representative will request your card for you. For your security, your card packet will come in a plain white envelope. The envelope will have an Indianapolis, Indiana return address. This packet has your reloadable debit card and instructions. Do not throw the packet away. This could delay receiving your funds. The packet will tell you how to activate and use your card. Do not try to use your card before it is activated. Your card will be denied.

For available reimbursement services and associated rates, refer to the Member Handbook, located in the Forms and Other Documents section of this web page.

To receive reimbursement, you must complete the following steps:

1. Call MTM Health at 1-877-503-1261 as soon as possible after scheduling your appointment. If your trip is urgent, let us know so we can verify the urgency of the appointment with your healthcare provider and expedite your request.
2. If your trip is approved, you will receive a trip number. We will either give you this number during this call or send it via email. Write the trip number down on your Trip Log. If anything changes during your trip (missed flight, changed appointment time, or additional appointments added), call us immediately. We will help you coordinate the changes and update the record for your reimbursement.
3. Complete the Trip Log or use the MTM Link Member mobile app. You may download a Trip Log under the Forms and Other Documents section of this web page, or you may request one be mailed to you. To receive reimbursement, you must submit a completed Trip Log with applicable invoices or receipts for all approved trips. You may also use the MTM Link Member mobile app to claim your trips without a Trip Log. The app is available for free on Apple and Android devices.
   • If you are using a paper log, make copies of your blank Trip Log in case you need to make changes.
   • The Trip Log must be signed by a healthcare professional at your appointment. This includes nurses, therapists, physician assistants, or nurse practitioner It doesn’t have to be the doctor.
   • A round trip is from your home to the appointment, then back home. Round trips should be entered on one line with the round trip box marked. If you are going from one appointment to another appointment before going home, please enter each trip leg on a separate line. For example:
     • 1st leg- home to first doctor
     • 2nd leg- first doctor to second doctor
     • 3rd leg- second doctor to home
   • Some trips will require additional review and you may be asked to call the MTM Health call center.

1. For long distance trip services (meals, lodging, ground transportation, and attendant services), please include the trip number and the appointment dates MTM Health provided to you in the approval with your itinerary (email or mail).
   • For lodging reimbursement, please include the date range of the travel, appointment dates, and the itemized hotel/lodging receipt.
2. Submit Trip Logs and any lodging receipts to MTM. Scan, fax, or take a picture of the Trip Log and receipts. Email them to payme@mtm-inc.net. Please submit your Trip Log and any receipts no more than 90 days past the date of the first appointment.
3. Keep a copy of your Trip Log for your records.

If you have questions about the reimbursement process, please call 1-877-503-1261.

As a recipient of Idaho Medicaid, you have certain rights. You have the right to:

• Receive information in a manner and format that may be easily understood and is readily accessible in accordance with 42 Code of Federal Regulations (CFR) § 438.10 – Information requirements.
• Be treated with respect and with due consideration for your dignity and privacy
• Receive information on available treatment options and alternatives, presented in a manner appropriate to your condition and ability to understand
• Participate in decisions regarding your healthcare, including the right to refuse treatment
• Exercise your rights without being worried about the way the NEMT program will treat you
• File a complaint or grievance related to MTM’s services without any penalty
• Request and receive a copy of your medical records, and request that they be amended or corrected, as specified in 45 Code of Federal Regulations (CFR) 164.524 – Access of individuals to protected health information and 45 Code of Federal Regulations (CFR) § 164.526 – Amendment of protected health information.

When utilizing NEMT to travel to an appointment, you must:

• Be ready for your ride at least 15 minutes prior to the scheduled pick-up time
• Never bring alcohol, drugs, or any weapon on the vehicle
• Use a seatbelt
• Use car seats for children as appropriate; if you do not have a car seat for your child, please let MTM Health know when you call to schedule your ride
• Bring your own wheelchair or other assistive devices and equipment if necessary
• Never smoke, vape, eat, or consume beverages while on board the vehicle
• Never physically or verbally abuse other passengers or the driver
• Be respectful and considerate of other passengers you share a ride with
• Cancel a ride you no longer need as soon as possible. If you do not cancel your ride and do not come outside when your driver arrives, you may be subject to corrective action. This could include no longer being eligible to receive NEMT services.

Drivers are required to follow certain rules as well. If you require it, the driver may help you into the vehicle, into a seat, secure your seatbelt, or provide first aid or other assistance. Any other touching is inappropriate and should be reported immediately to MTM. Please file a complaint with MTM Health if:

• Your driver is driving dangerously
• Your driver is under the influence of alcohol, narcotics, illegal drugs, or other drugs
• Your driver is smoking or vaping in the vehicle
• The heat or air conditioning in the vehicle is not working properly
• There is no seat or seatbelt for you in the vehicle
• The driver did not pick you up
• The driver is more than 15 minutes late
• Your driver is texting while driving or using a cell phone that is not in hands-free mode
• Your driver is rude or disrespectful

MTM Health respects your right to privacy. We abide by all privacy and security laws. This includes Health Insurance Portability and Accountability Act (HIPAA). You have rights when it comes to protecting your health information, such as your name, Medicaid identification number, race, ethnicity, and other things that identify you. We will not share health information about you as required by law. If you have any questions, call 1-877-503-1261.

MTM Health has several ways that you can get help with NEMT services:

• If you have general questions about NEMT services or need help scheduling a ride, please call 1-877-503-1261. You may reach us 24 hours a day, seven days a week using this phone number. Our Customer Care Representatives can answer all of your questions. We can help you schedule a ride and explain any changes that might affect your transportation benefits.
• If you have questions about the reimbursement process, please call 1-877-503-1261.
• If you need to reach US Bank Cardholder Services for help with your reloadable debit card, please call 1-888-863-0681.
• If you need help using the MTM Health Member Portal or mobile app, please call our Navigator Line at 1-888-597-1189. A Representative will be able to assist you in creating your account or troubleshooting any issues you have using the platforms.

If you do not speak English, call us at 1-877-503-1261. We have access to interpreter services. This service helps us speak to you in your language. We provide this help for free.  

For people with disabilities: If you use a wheelchair, are blind, or have trouble hearing or understanding, call us if you need extra help. Also, we have services like:

• Telecommunications Relay Service. This helps people who have trouble hearing or talking to make phone calls. Call 711 and give them our trip reservation line phone number. It is 1-877-503-1261. They will connect you to us.
• Information and materials in large print, audio (sound); and braille.
• Help in making or getting to Our Elevate managed members team provides one-on-one, specialized assistance for members who have specific travel needs. If you need personalized assistance, you will be assigned to this team, which will provide a single point of contact for your NEMT needs.

All of these services are provided on request and free of charge.

We want you to be happy with us and the rides you receive from our transportation providers. Let us know right away if at any time you are not happy with anything. This includes if you do not agree with a decision we have made.

If you are not happy with MTM Health or our providers, you can file a Complaint. To file a complaint, you can:

• Call 1-866-436-0457
• Visit mtm-inc.net/contact
• Write to us at:
  • MTM, Inc.
  • 16 Hawk Ridge Drive
  • Lake Saint Louis, MO 63367
  • Attention: Quality Management

We will follow up with you via phone call, email, or mailed letter to resolve your complaint.

If you disagree with a denial or other decision made by MTM, you can file a Grievance or Appeal. You can do any of the following within 28 days of the date on your decision letter:

• Call 1-866-436-0457
• Write to us at:
  • MTM, Inc.
  • 16 Hawk Ridge Drive
  • Lake Saint Louis, MO 63367
  • Attention: Quality Management

We will review your grievance or appeal and send you a letter with our decision within 30 days. If we need more time to solve your grievance or appeal, we will send you a letter with our reason and tell you about your rights if you disagree.

If you do not agree with our appeal decision, you can ask for a Medicaid Fair Hearing.

You can:

• Submit a written appeal to Medicaid Appeals at the Idaho Department of Health and Welfare (Department).
• Ask us for a copy of your medical record.
• Ask for your services to continue after receiving our letter, if needed. Some rules may apply.

We will provide you with transportation to the Medicaid Fair Hearing, if needed, and will restart your services if the state agrees with you.

If the Department can’t resolve your appeal, it will go to a fair hearing. The Office of the Attorney General’s Fair Hearing Unit will review your appeal. A hearing officer will hold a hearing by telephone with you and the Department to review your appeal request. It could take up to 30 days after the hearing to make a decision. If it’s an expedited review, the hearing officer will review your appeal as soon as possible.

With your permission, a relative, friend, advocate, doctor, or lawyer can also file an appeal or speak for you during the appeal process if they are designated as an “authorized representative.” You need to let the Department know by letter, email, or on the appeal form if you have an authorized representative. Your authorized representative will receive updates about your appeal.

To request a Fair Hearing, contact the Department or visit your local Health and Welfare office in person:

IDHW
Medicaid Appeals
P.O. Box 83720
Boise, ID 83720-0009
1-866-434-8278 (Fax)
MedicaidAppeals@dhw.idaho.gov