COOK COUNTY CONNECTIONS: Health Care Access Reimbursement for Non-Emergency Medical Transportation Services
Oct 16, 2020 08:37AM
Cook County Public Health and Human Services (PHHS) administers the Health Care Access program for residents of Cook County who are enrolled in Medical Assistance (Medicaid). The program reimburses Medical Assistance recipients for expenses that are required to access their medical care. Expenses that can qualify for reimbursement include: mileage, parking, meal, and medical lodging. Medical Assistance recipients must provide documentation and expenses must meet certain criteria to be eligible for reimbursement. Policy and reimbursement rates for the Health Care Access program are set by the MN Department of Human Services. The Health Care Access program is funded primarily through state and federal dollars.
The Health Care Access program is an important financial support for eligible community members that assists them in accessing medical care. In 2018, over $25,500 was provided to Cook County residents, in pre-authorized services and expense reimbursement, to help them access medical appointments. Those funds assisted over 70 households with medical expenses including mileage reimbursement, parking fees, meal reimbursement while in travel status, and medical lodging when travel was required for medical care.
The Health Care Access program reimbursed expenses of nearly $19,000 in 2019. These resources helped over 60 households households with medical expenses including mileage reimbursement, parking fees, meal reimbursement while in travel status, and medical lodging when travel was required for medical care.. Households that utilize the Health Care Access program often do so with regularity which speaks to the beneficial nature of the program. The Health Care Access program promotes health and well-being among our community and ensures that medical care remains accessible for all.
You must be enrolled in Medical Assistance to be eligible for reimbursement through the Health Care Access program. There are currently 1,000 individuals enrolled in Medical Assistance in Cook County; however, less than 10% of eligible members currently utilize the Health Care Access program. There is great potential to increase this program’s benefit to our community by boosting member participation. If you have questions about your eligibility, please contact Cook County PHHS at 218-387-3620 and ask to be connected with the Health Care Access Coordinator or a Financial Worker.
There are additional requirements to consider when requesting reimbursement through the Health Care Access program. The appointment must be for a medical service that is eligible for payment by Medical Assistance. The Health Care Access program will pay for the most cost-effective form of transportation to get a member to the closet provider capable of providing the level of care needed. Medical care is limited to within 30 miles of your home for primary care and within 60 miles of your residence for specialty care. If care is required that would exceed these distances, a member is required to have their primary care provider complete the “Referral for Out of Area Medical Care” and submit that with the claim. Written and signed verification is required from your medical provider to document the need for a companion who would then be eligible for reimbursement of meal and lodging costs at the same rate. These requirements ensure consistent application of the program policies and the integrity of program payments.
Health Care Access Process
All Medical Assistance members receive information on the Health Care Access program when they enroll in their health plan. This paperwork includes a Health Care Access notice, policy, claim form, and referral. If a Medical Assistance member would like to be reimbursed for mileage or expenses related to travel for health care, they would need to complete the claim form and submit it within 30 days after the medical appointment. Claims must be submitted to: Cook County PHHS, 411 West 2nd Street, Grand Marais, MN 55604. Each claim must be for only one recipient, include detailed appointment information, include a signature from the treating provider (support staff), and a signature of the claimant. Medical care requiring travel that exceeds the mileage limit would also require a referral from a primary care provider.
If you need additional Health Care Access forms, please contact Cook County Public Health and Human Services prior to your appointment. There may also be situations which would allow for a pre-authorized advance of gas cards; check with the Health Care Access Coordinator to see if you are eligible. Prior authorization is required for overnight stays as these are arranged to be direct billed to PHHS. Medical stays require documentation that no other appointment is available that would allow for same day travel. Receipts are required to be submitted with the claim for medical lodging, meal, and parking reimbursement; these must include a date and time. Claims are processed within 30 days of their receipt at the agency and reimbursement checks mailed for approved qualified expenses. If you have questions about the Health Care Access program, please contact the Health Care Access Coordinator at 218-387-3620.
Learn more about the Health Care Access program at the October 20th PHHS Board Meeting at 8:30 a.m. The meeting is available to stream live on the Cook County website at www.cookcountyphhs.org. Contact us via email at [email protected] or follow us on Facebook @CookCountyPHHS or on Instagram @Cook_County_PHHS to learn more about our work in supporting the health, safety and wellbeing of Cook County.
County Connections is a column on timely topics and service information from your Cook County government. Cook County – Supporting Community Through Quality Public Service