Hoosier Healthwise Transportation Services Fact Sheet

Transcription

1 Hoosier Healthwise Transportation Services Fact Sheet Many individuals who are covered by Medicaid do not have reliable transportation and/or need assistance getting to medical appointments. This is especially true when individuals must see providers not located in close proximity to their homes. We have designed this fact sheet to aid Hoosier Healthwise members to arrange transportation to medical appointments. My family member is covered by Hoosier Healthwise. Does HHW cover transportation services? In short, yes. The extent of these services varies by package and health plan. Hoosier Healthwise covers certain medically-related transportation services for its members. Individuals covered under Packages A and B can request transportation to medical appointments. Depending upon their health plan (Anthem, MDwise Inc., or MHS), Package A and B members may receive additional transportation services. Package C members can get ambulance transportation for emergencies at a greatly reduced cost. Help! I don t know which package I m covered under. How do I find this information? You can find this information by reviewing your letter of eligibility or calling the HHW helpline at In most cases, your doctor s office can also tell you this information. If you do not pay a premium for services, you are likely covered under Package A or B. Package A is the standard, full-service plan for children, some pregnant women, and families who are income-qualified. This plan does not carry a premium though copays may apply for certain services. Package B is pregnancy only coverage for pregnant women who do not qualify for Package A. Package C is also known as CHIP (Children s Health Insurance Program) and covers preventative, primary and acute care services for children under the age of 19. Members are charged small, monthly premiums and copays based upon family income. What is a health plan, and how do I know which one manages my HHW? When you joined HHW, you had to choose a health plan. The health plan manages your care and consists of a group of providers and services. HHW offers three health plans: Anthem, MDwise Inc., and Managed Health Services (MHS). You should have received correspondence from your health plan, including a benefits handbook, after enrolling. The handbook will list all benefits, including transportation services, as well as any procedures you must follow to obtain those services. If you do not know which health plan you are enrolled in, you may call the HHW helpline at Have your member card ready when you call. I do not have a benefits manual from my health plan. How do I know what is covered? If you do not have a benefits manual, you may request one from your health plan by calling the number listed below. Alternatively, you may visit the health plan s website to find a Member Handbook.

2 Anthem: , MDwise Inc.: , Inc..org/ Managed Health Service (MHS): , I am interested in learning about my transportation benefits. Where can I find this information? All benefits, including transportation benefits, are listed in the health plan handbooks. Alternatively, you may use this fact sheet to learn more about your HHW transportation benefits. Locate your plan s transportation benefits below: Anthem, page 3 MDwise Inc., page 4 Managed Health Services, page 5. 2

3 Hoosier Healthwise Transportation Services: Anthem I am covered under HHW Package A or B and by Anthem. What transportation benefits do I receive? Package A and B Members receive nonemergency and emergency transportation benefits. Nonemergency transportation benefits include 20 one-way trips of less than 50 miles per year to medical appointments. Members needing additional transportation services or who require transportation greater than 50 miles should contact member services for a prior authorization. Emergency transportation is available in the event of a true emergency. How do I arrange for nonemergency transportation?as soon as you make your doctor s appointment, contact LCP Transportation Services by calling to schedule a ride. How do I get emergency transportation? Call 911. I am covered under HHW Package C and by Anthem. What transportation benefits do I receive? Individuals covered under Package C receive emergency transportation services. Non-emergency transportation is covered only when a network physician requests hospital-to-hospital transport. Both types of transportation services incur a $10 copay. Individuals needing emergency transportation should call 911. What do I do if I encounter a problem accessing transportation services? To report a problem with transportation services, contact Anthem at or submit a Member Grievance Form ( to Anthem. It is important to be thorough and specific when detailing concerns about transportation services. When applicable, we recommend using the verbiage, ease of access when reporting transportation problems. For example, Ease of access is the primary concern 3

4 Hoosier Healthwise Transportation Services: MDwise Inc. I am covered under HHW Package A or B and by MDwise. What transportation benefits do I receive? Package A and B Members receive nonemergency and emergency transportation benefits. Nonemergency transportation benefits include 20 one-way trips of less than 50 miles per year to doctor appointments that are covered by MDwise. Members needing additional transportation services or who require transportation greater than 50 miles should contact member services for a prior authorization. If available in your area, MDwise may issue you a bus pass for your trip to the doctor. A bus pass counts as two trips towards your trip limit. Any trips remaining on the pass may be used to go to the pharmacy or other important appointments. Emergency transportation is available in the event of a true emergency. How do I arrange for nonemergency transportation? You must make your transportation request at least two business days before the scheduled appointment. If you have an urgent medical need, you may still request transportation. As soon as you make your doctor or dental appointment, call , or in the Indianapolis area, between the hours of 7:00 am and 7:00 pm, Monday-Friday. Follow the prompts on the telephone; choose the HHW option, then pick transportation. When you call, have your HHW card and the following information available: Your address and phone number Date and time of the appointment Name, address and phone number of the doctor or clinic Total number of passengers Time you think the appointment will end. How do I get emergency transportation? Call 911. I am covered under HHW Package C and by MDwise. What transportation benefits do I receive? Individuals covered under Package C receive emergency transportation services only. What do I do if I encounter a problem accessing transportation services? If you encounter a problem when accessing transportation services, contact MDwise customer service at within 60 days of the incident. An MDwise customer service representative will file a grievance. It is important to be thorough and specific when detailing concerns about transportation services. When applicable, we recommend using the verbiage, ease of access when reporting transportation problems. For example, Ease of access is the primary concern 4

5 Transportation Services: Managed Health Services (MHS) I am covered under HHW Package A or B and by MHS. What transportation benefits do I receive? Package A and B Members receive nonemergency and emergency transportation benefits. Nonemergency transportation benefits include transportation to medical appointments covered by Indiana Medicaid, to pick up prescriptions from the pharmacy after a covered visit, or to renew HHW coverage. Emergency transportation is available in the event of a true emergency. How do I arrange for nonemergency transportation? You must make your transportation request at least three business days before the scheduled appointment. If you have an urgent medical need, you may still request transportation. As soon as you make your doctor or dental appointment, call between the hours of 8:00 am and 8:00 pm, Monday-Friday. When you call, have your HHW card and the following information available: Your address and phone number Date and time of the appointment Name, address and phone number of the doctor or clinic Total number of passengers* Accessibility needs, such as whether you will need a vehicle with wheel chair access and/or help to/from the building to the vehicle Car seat needs; if a car seat is needed, you must tell the customer representative when scheduling the ride. *Please note: MHS provides transportation for the HHW member who has a scheduled appointment and one family member. In the event that multiple family members must accompany the HHW member, the request for additional seats must be made at the time of scheduling. All riders under the age of 16 years must be accompanied by an adult who is 18 years or older. After your appointment, you must call MHS transportation services to be picked up. Pick-up times may vary between 15 minutes and 2 hours. You must request pick up from the drop-off location. Transportation may take members to the pharmacy on the way to their final destination. How do I get emergency transportation? Call 911. I am covered under HHW Package C and by MHS. What transportation benefits do I receive? Individuals covered under Package C receive emergency transportation services only. Call 911 for an ambulance. What do I do if I encounter a problem when accessing transportation services? If you are dissatisfied with the transportation services provided, please contact MHS member services at It is important to be thorough and specific when detailing concerns about transportation services. When applicable, we recommend using the verbiage, ease of access when reporting transportation problems. For example, Ease of access is the primary concern 5

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