Medicaid: Non-Emergency Medical Transportation (NEMT)

Where We Stand

NAMI believes that public policies and practices should promote access to care for people with mental health conditions. NAMI opposes efforts to limit or eliminate non-emergency medical transportation (NEMT) in Medicaid, a critical benefit for people with mental health conditions.

Why We Care

Access to mental health treatment, services and supports is vital for people with mental illness to get well and stay well. For many, having reliable, affordable transportation to and from medical appointments can be a major hurdle to accessing mental health care. Each year, millions of people miss medical appointments due to unavailable or unaffordable transportation. This limits opportunities for individuals to manage their mental health needs, often resulting in the need for more costly health care services and leading to worse health outcomes.

Currently, all state Medicaid programs must cover NEMT, which helps people get transportation to necessary medical care, including mental health care. People enrolled in Medicaid are significantly more likely to receive care through recommended medical appointments when using NEMT, and the majority of individuals on Medicaid agree that they would not be able to keep medical appointments without it. NEMT is particularly important for people with mental illness, since behavioral health services are the most frequently cited reason for using NEMT.

NEMT represents only a small share of Medicaid spending, yet it helps people access timely medical care, preventing more costly trips like ambulance rides to the emergency room. The use of NEMT results in an average monthly savings of $1,300 per person. Protecting NEMT benefits is an important way for people to get the services and supports they need to get well and stay well.

How We Talk About It

• Mental health treatment is critical for many people experiencing a mental health condition to manage their symptoms, but it is only helpful if a person can access it.
• When a person has no way to get to a health care appointment, even the best mental health services won’t help.
• Without transportation options to get to medical care, treatable conditions can worsen and become more serious — and more expensive to treat.
• To help people covered by Medicaid access care, all states must cover non-emergency medical transportation (NEMT) in their Medicaid programs.
• NEMT helps people get to non-emergency medical appointments, and many people with mental illness covered by Medicaid rely on it.
• When a state or the federal government limits or eliminates NEMT services, people may not be able to get help when they need it.
• Without timely care, people with mental illness see their symptoms worsen and can often end up in emergency rooms, hospitals and even jail — leading to higher costs and worse outcomes for the individual.
• NEMT has been shown to make it significantly more likely that a person can make it to their appointments.
• NEMT is only a small share of overall Medicaid spending — while also helping to save money by helping people maintain ongoing care.
• Despite the many benefits of NEMT, a few states have received permission from the federal government to limit their Medicaid NEMT benefit, which creates additional barriers to care for people with mental health conditions.
• Medicaid should encourage individuals to access needed health and mental health care early and to engage in ongoing treatment. Protecting the NEMT benefits is an important way for people to get the services and supports they need to get well and stay well.

What We’ve Done

• NAMI works with Medicaid Transportation Access Coalition to advocate for NEMT
• NAMI letter to HHS Inspector General about the importance of the NEMT benefit