Qualification for Transportation Services
A Complete Guide to Non-Emergent Medical Transportation Eligibility
Understanding whether you qualify for Non-Emergent Medical Transportation (NEMT) services is the first step toward accessing reliable transportation to your medical appointments. This guide will walk you through all the requirements and help you determine your eligibility for services with Golden Gate Manor Transportation. We understand how things can seem complicated, especially without any help, and that's why our team is available during any step in the process.
What is NEMT Eligibility?
NEMT is a Health First Colorado (Colorado Medicaid) program benefit designed to help members who don't have transportation access get to their medical appointments. To ensure these services reach those who need them most, there are specific eligibility requirements that must be met.
Our goal is to make the qualification process as clear and straightforward as possible, so you can quickly determine if you're eligible and begin accessing the transportation services you need.
Basic Eligibility Requirements
To qualify for NEMT services with Golden Gate Manor Transportation, you must meet all of the following criteria:
Insurance Coverage
You must have current Health First Colorado (Medicaid) insurance. This is the foundation of NEMT eligibility. Your Medicaid coverage must be active and in good standing.
Important: CHP+ is not a Medicaid program and therefore does not qualify for NEMT services.
You cannot be in the following designation groups:
- Qualified Medicaid Beneficiary (QMB)
- Special Low-Income Medicare Beneficiary (SLMB)
- Medicare Qualifying Individual-1 (QI-1)
- Old Age Pension - State Only (OAP-state only)
Medical Purpose
Your trip must be for non-emergency Medicaid-eligible transportation to covered medical services. Examples include doctor appointments, specialist consultations, physical therapy sessions, mental health appointments, dialysis treatments, lab work, diagnostic imaging, routine check-ups, and prescription pickups. Emergency situations should use 911 services instead.
Service Area
You must live within our service area for pickup. Golden Gate Manor Transportation serves all Colorado counties except the Denver metro area (Boulder, Larimer, Weld, Broomfield, Denver, Adams, Jefferson, Douglas, and Arapahoe counties) for pickup services. However, we can transport you from our service areas to medical appointments located in areas we don't typically service on a case-by-case basis. We simply cannot provide pickup services from the Denver metro counties as those areas fall under different transportation jurisdictions.
Required Documentation
Medical Certificate of Transportation Services
Before you can use NEMT services, your healthcare provider must complete and sign a Medical Certificate of Transportation Services form. This document establishes the medical necessity for transportation services.
Who can complete this form:
- Your attending physician
- Physician's assistant
- Nurse practitioner
- Therapist
- Licensed healthcare professional
When you need this: This form is required before your first NEMT ride and must be renewed periodically as determined by your healthcare provider.
Additional Documentation for Long-Distance Travel
If you live more than 25 miles from your medical provider, additional documentation is required to verify the medical necessity of the extended travel distance.
What you need: Your medical provider must complete the "Verification Form for Transportation Services More Than 25 Miles" to confirm that the distant location is necessary for your specific medical needs.
This form can be found within the Medical Certificate of Transportation Service Form linked above.
Covered Medical Services
NEMT transportation is available for appointments and services that are covered by Health First Colorado (Medicaid).
Commonly covered services:
- Primary care physician visits
- Specialist appointments
- Diagnostic testing and lab work
- Therapy sessions (physical, occupational, speech)
- Mental health and substance abuse treatment
- Dialysis treatments
- Chemotherapy and radiation treatments
- Prescription pickup (in limited circumstances)
Important: We cannot provide transportation to services that are not covered under the Medicaid program. If you're unsure whether your appointment qualifies, we can help verify coverage during the scheduling process.
What Disqualifies You from NEMT
You may not qualify for our NEMT services if:
- You don't have active Health First Colorado (Medicaid) coverage
- Your appointment is not for a Medicaid-covered service
- You live outside our service area
- You're in one of the excluded Medicaid designation groups listed above
- You need transportation for non-medical purposes
Getting Help with Qualification Questions
Understanding NEMT eligibility can sometimes be complex, especially if you have unique circumstances or questions about coverage. Our experienced customer service team is here to help you navigate the qualification process, whether you need assistance with questions about your Medicaid coverage eligibility, help determining if your appointment qualifies, guidance understanding required documentation or the Medical Certificate process, or clarification about our service area coverage.
We're here to help make the qualification process as smooth as possible. Don't hesitate to reach out if you have questions or need assistance understanding any part of the eligibility requirements.
Next Steps After Qualifying
Once you've determined that you qualify for NEMT services, you'll need to complete your Medical Certificate with your healthcare provider and gather your appointment information and personal details. Next, review our scheduling guide to understand the booking process, then contact us to schedule your first ride at least 24-48 hours in advance.
Ready to get started? Visit our Getting Ready for Your First Ride guide for detailed preparation information, or our How to Schedule a Ride guide to begin booking your transportation.