Our goal is help you reach a healthier you. We want to be there for you every step of the way. That is why WellCare of North Carolina offers to help set up and pay for your transportation to and from medical appointments.
If you need emergency transportation, call 911.
Medicaid can help get you to and from appointments. This service is at no extra cost to you. You can also ask for an attendant to come with you to your appointment. We cover transportation for a child member’s attendant, parent, or guardian.
Non-emergency transportation includes:
- personal vehicles
- mountain area transports
- public transportation.
The service takes you to the closest medical provider for your needs. This is only for Medicaid covered services. WellCare offers NEMT services as a value-added benefit to North Carolina Health Choice members.
WellCare of North Carolina has partnered with One Call. One Call is a transportation broker. This partnership helps provide Non-Emergency Medical Transport services.
You have two options to get the services you need. You can call One Call directly or call WellCare Member Services and follow the directions below:
Only plan services are covered. Your level of need determines your transportation mode. Drivers will wait up to 5 minutes after arrival for pickup. If you no longer need transportation to an appointment, please call One Call at 1-877-598-7602 or WellCare Member Services at 1-866-799-5318. Select option for Transportation.
One Call is also available outside of normal business hours. This is only for urgent non-emergency transportation needs. If your need is urgent, select “Urgent Trip Request” when you call.
We may also cover travel costs. This includes:
To receive reimbursement, call One Call. Call in advance of your appointment to schedule the trip. You will be provided instructions on how to complete the reimbursement form. You will need to submit the required documentation for reimbursement.
Those that need a wheelchair or some other accommodation will need a Level of Need form . This form must be completed by your primary care physician or treating provider. One Call will need this form when you make your appointment. In addition, certain transportation services require prior authorization by WellCare, including:
- trips over 75 miles one-way
- out-of-state trips (40+ miles over border)
- air ambulance
- trips requiring hotel, flight, and/or meals.
You must first call One Call. Then, One Call will inform WellCare. WellCare will contact your primary care physician or treating provider. This is required to complete the steps for prior authorization. One Call will follow up with you to finish scheduling the appointment.
We may deny you this service. If denied service, you may appeal. To appeal:
- Call 1-866-799-5318
- Select option for Member assistance on appeals.
Members must comply with the transportation member conduct and no-show policies. The member conduct and no-show are reviewed with members when scheduling NEMT services:
- If a member does not follow conduct rules One Call, in consultation with WellCare, will address the situation
- We will work with care managers and PCPs or treating providers as necessary to address any issues the member may be experiencing
- One Call drivers are trained to de-escalate and collaborate with the member to address their concerns
- Drivers may also contact 911 if they feel there is imminent danger
- The member will receive written communication from WellCare regarding inappropriate behavior, including no shows, and the consequences, which may result in suspension of transportation services
- In the case of suspension of transportation services, if the member schedules transportation to Medicaid covered services through One Call in advance and as long as he/she remains otherwise eligible for transportation assistance, the member shall be provided mileage reimbursement.
- To be informed of the availability of Medicaid transportation services available at no cost
- To have the transportation policy explained including how to request a trip or cancel a trip, limitations on transportation, personal conduct and no-shows
- To be transported to medical appointments if unable to arrange or pay for transportation
- By means appropriate to circumstances
- To arrive at medical provider in time for their scheduled appointment
- To be informed that a Member under the age of eighteen (18) does not have to ride alone and member, and attendants can ride at no additional cost
- To request a hearing if the request for transportation assistance is denied.
- To use those transportation resources which are available and appropriate to their needs in the most efficient and effective manner
- To utilize transportation services, such as gas vouchers, appropriately
- To travel to the requested location and receive a Medicaid covered service
- To make timely requests for transportation assistance
- To be ready and at the designated place for transportation pick-up or cancel the transportation request timely
- To follow the instructions of the driver
- To respect and not violate the rights of other passengers and the driver, such as not creating a disturbance or engaging in threatening language or behavior.