Medicaid Recipient Transportation

South Dakota Medicaid covers transportation for Medicaid recipients to medical appointments and in some instances to pick-up prescription drugs, durable medical equipment, and optical supplies when:

• The medical service is covered and medically necessary. Note: For out of state services, this means that the service has been prior authorized by South Dakota Medicaid.
• The transportation provider is enrolled with South Dakota Medicaid. Before booking transportation, remember to ask if the provider is enrolled in South Dakota Medicaid and if the trip will be covered by Medicaid. Remember to give the transportation provider your Medicaid ID card. Note: This does not apply to Non-Emergency Medical Travel program.
• Transportation is to the closest medical provider capable of providing the services. An exception to this requirement is allowed if you have a written referral from a medical provider.
• The trip is for the first fill of a new prescription, medical equipment fitting, or medical equipment adjustment.
• Delivery or mailing is not an option for obtaining the prescription, equipment, or supply.

If a recipient has multiple prescriptions or DME items, orders must be coordinated for pick-up on the same date from the same provider/location whenever feasible.

South Dakota Medicaid also covers transportation services for an accompanying adult to a medical service for a recipient who is a child age 20 or younger if an accompanying adult is necessary for the transportation service or medical service to occur.

Ambulance

Transportation by an ambulance is only covered for life threatening emergencies. South Dakota Medicaid covers ground ambulance and air ambulance, if necessary. Do not call an ambulance for non-emergency transportation.

Example: John is in a car accident and suffers life threatening injuries. He is transported to a hospital by ambulance.

Secure Medical Transportation

Secure medical transportation is non-emergency transportation for individuals who rely on a wheelchair or stretcher to move around. It is not covered for individuals who do not need a stretcher or wheelchair for mobility purposes. Transportation must be from your home to a medical provider (including pharmacies and optical or DME providers) between medical providers or from the medical provider to your home. A list of secure medical transportation providers is available on our website.

Example: Jack uses a wheelchair to move around. A wheelchair van takes him to an appointment with his health home provider.

Community Transportation

Community transportation providers can transport you to non-emergency medical appointments and to pick-up prescription drugs, durable medical equipment, and optical supplies. Transportation must be from your home or school to a medical provider (including pharmacies and optical or DME providers), between medical providers or from a medical provider to your home or school. A list of community transportation providers is available on our website.

Example: Jane has an appointment with her dentist. She takes a city bus that is an enrolled Medicaid provider to the appointment.

Non-Emergency Medical Travel

The Non-Emergency Medical Travel (NEMT) Program reimburses travel to medical appointments and to pick-up prescription drugs, durable medical equipment, and optical supplies outside your city of residence. NEMT reimburses you for mileage and may reimburse you for meals and lodging if overnight travel is necessary and the provider you are seeing is at least 150 miles from your city of residence.

Example: Jane lives in Pierre and has an appointment with a specialist in Sioux Falls. She drives herself to Sioux Falls for the appointment.

More information about NEMT limitations and reimbursement is available on the NEMT page.