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last modified 07/02/2018 - 01:44 PM

Non-Emergency Medical Transportation (NEMT): Medicaid provides transportation to appointments for covered services to members who don't have access to their own transportation.



  • As of 7/1/17 all calls should be directed to Vermont Public Transportation Association (VPTA): Toll free 1-833-387-7200.


  • Out-of-Area/Out-of-State Transportation Physician Referral Form (Last updated on 07/01/2017Referral form necessary for transportation request over 60 miles from members residence to a participating provider.
  • Public Transportation Medical Exemption Form  (Last updated on 07/01/2017) Form to be filled out by provider’s office if medical conditions warrant the use of any specific mode of transport, or if medical conditions limit which modes may be utilized by the transportation provider.    
  • Child Accompaniment Exception Application (05/01/2015) Form to be used if member is requesting that a child under the age of 6 accompany the member to a scheduled appointment. 
  • Vehicle Exception Form (07/01/2017) Form to be filled out by member if vehicle(s) in household are not available for the transport of members to scheduled appointments.
  • Transportation Employment Exception Verification Form (07/01/2017) Form to be filled out by the employer of the member of the household who is unable to transport the member to scheduled appointments. 

  • Hardship Mileage Waiver Form (07/01/2017) Form to be handed out by sub-contractor and filled out by member if requesting hardship mileage reimbursement under the Hardship Mileage Program guidelines. Member needs to go through sub-contractor to be eligible for this program.