Emergency medical transportation is an ambulance called through 911 for a sudden, possibly life-threatening problem, with a crew that treats the patient on the way to the emergency room. Non-emergency medical transportation (NEMT) is a scheduled ride for someone who is medically stable but can’t safely drive or ride in a regular car, such as a wheelchair user going to dialysis or a patient going home from the hospital on a stretcher. The simple test: if the person needs medical care right now or during the ride, it’s an emergency or an ambulance trip; if they need help getting there, it’s NEMT.
The difference matters for safety, for cost and for insurance. Here is how to tell which one you need, where a non-emergency ambulance fits in between, and what H&M Transport can and can’t do.
Emergency vs. non-emergency medical transportation at a glance
- Purpose. Emergency transport responds to a crisis. NEMT gets a stable person to or from a planned appointment, discharge or facility move.
- How it’s arranged. Emergency: call 911. NEMT: book ahead by phone, online or through a facility, usually hours or days in advance.
- Who’s on board. Ambulances carry EMTs or paramedics who assess and treat. NEMT vehicles carry trained drivers and crews who help with mobility and transfers but provide no medical care.
- Vehicle. Ambulances are mobile treatment rooms with monitors, medications and life-support equipment. NEMT uses accessible vans with ramps or lifts, wheelchair securement and stretcher cots.
- Destination. Emergency trips go to the emergency department. NEMT goes to clinics, dialysis centers, outpatient procedures, rehab, nursing homes and home.
- Cost. NEMT is typically a fraction of the cost of an ambulance trip, which is why insurers and hospitals prefer it whenever a patient doesn’t need medical care en route.
When to call 911 instead of booking a medical ride
Call 911 for anything that looks sudden, severe or life-threatening. Don’t book a van, and don’t drive the person yourself if their condition could get worse on the way. Common examples:
- Chest pain or pressure, or trouble breathing
- Signs of a stroke, such as face drooping, arm weakness or slurred speech
- Fainting, a seizure or new confusion
- A serious fall, especially with a head injury or a possible broken hip
- Heavy bleeding, a severe allergic reaction or a sudden, severe pain
An NEMT provider will never take a patient to an emergency room, and a driver who sees a rider in distress will call 911. If you’re unsure, call 911 or the patient’s doctor. It is always better to over-call than to wait.
What non-emergency medical transportation is for
NEMT covers the much larger set of trips where the person is stable but a car, taxi or rideshare won’t work. At H&M Transport, that means four levels of service:
- Ambulatory: for riders who can walk with some help. Door-through-door; the driver assists from inside the home to inside the destination.
- Wheelchair transport: the rider stays in the chair, which goes up a ramp or a hydraulic lift and is secured at four points. We can bring a chair at no extra cost.
- Stretcher transport: bed-to-bed service for people who can’t sit upright for the trip, always with at least two crew members and power-assisted cots.
- Bariatric: for riders over 300 lb, in specialized vehicles with wider ramps and roomier interiors.
Typical trips include dialysis, chemotherapy and radiation, physical therapy, follow-up visits, outpatient procedures under sedation, hospital discharges to home, and scheduled moves between facilities, such as hospital to a rehab center or nursing home. For a full picture of the category, see our guide to what NEMT is and who uses it.
Non-emergency ambulance uses: the middle ground
Between a 911 call and a wheelchair van sits the non-emergency ambulance. It’s scheduled like NEMT, but it’s still an ambulance, staffed by EMTs or paramedics, because the patient needs clinical attention during the ride. Common reasons a doctor or discharge planner orders one:
- The patient needs continuous monitoring, such as heart monitoring, during transport
- The patient needs IV medications or fluids running during the trip
- The patient’s oxygen needs to be adjusted or monitored by a clinician
- The patient needs suctioning, a ventilator or other airway support
- The patient’s condition is unstable enough that a medical professional must be present
- A transfer between hospitals for a higher level of care
None of those are NEMT trips. H&M Transport does not provide medical care or monitoring on board and does not handle hospital-to-hospital transfers for a higher level of care. If any of the above apply, the care team should arrange a non-emergency ambulance.
The reverse is also true. Some patients who need to lie flat for the ride don’t need to be monitored. A stable patient who can’t sit up, but who needs no medical care in the vehicle, can usually go by stretcher van, which is typically far less expensive. The patient’s care team decides which fits.
How insurance treats emergency and non-emergency transport
Coverage is one of the biggest practical differences.
Medicare. Medicare Part B covers ground ambulance transportation when traveling in any other vehicle could endanger your health, and non-emergency ambulance trips generally need a written doctor’s order stating they’re medically necessary. After the Part B deductible, you typically pay 20% of the Medicare-approved amount, according to Medicare.gov. Original Medicare does not cover wheelchair or stretcher vans. Some Medicare Advantage plans include a transportation benefit, so check your plan.
Virginia Medicaid. Call the transportation number on your Medicaid ID card; the brokers we work with are MTM Health and SafeRide Health. Request H&M Transport specifically when you book your ride.
Maryland and DC. H&M Transport is not a Medicaid provider in Maryland; in Montgomery County, Medicaid rides go through the county Department of Transportation’s Medical Assistance Transportation Program. In DC, the only Medicaid plan we serve is UnitedHealthcare Community Plan of the District of Columbia, through SafeRide Health. In Montgomery, Prince George’s and DC, riders whose plan’s ride benefit is administered by SafeRide Health can book through the plan and request H&M Transport by name.
Private pay. Many families pay directly for NEMT. Prices are the same across Virginia, Maryland and DC and are posted on our rates page. As an example, a 10-mile wheelchair round trip is $140, and a 10-mile stretcher discharge is $300.
How hospitals and facilities choose between them
For discharge planners and nursing staff, the decision usually comes down to three questions:
- Does the patient need any clinical care or monitoring during the ride? If yes, a non-emergency ambulance. If no, NEMT.
- Can the patient sit upright safely for the length of the trip? If yes, ambulatory or wheelchair. If no, stretcher.
- Is the patient going to a higher level of care? If yes, that’s an ambulance transfer, not NEMT.
Hospitals, skilled nursing facilities, dialysis centers and hospices can set up an account and book on contracted rates. For facility discharges, we work to a three-hour maximum lead time.
Why H&M Transport for non-emergency rides
H&M Transport has been running non-emergency medical rides since 2010 from our dispatch center in Gainesville, Virginia, and was the first NEMT provider in Virginia to earn NEMTAC accreditation. We run 80+ wheelchair vans across Northern Virginia, DC and the Maryland suburbs of Montgomery and Prince George’s counties under WMATC authority 3449, and dispatch answers 24/7, holidays included.
Common questions
Is NEMT the same as a non-emergency ambulance?
No. A non-emergency ambulance carries EMTs or paramedics who can treat and monitor the patient. NEMT provides assisted transportation for stable patients with no medical care on board.
Can an NEMT van take someone to the emergency room?
No. If someone needs emergency care, call 911. H&M Transport does not transport to emergency rooms.
Can you move a patient from a hospital to a nursing home?
Yes, if the move is a stable, scheduled transfer, such as hospital to rehab or a nursing home. We don’t do hospital-to-hospital transfers for a higher level of care.
Does Medicare pay for a wheelchair van?
Original Medicare does not cover wheelchair or stretcher vans. Some Medicare Advantage plans include a transportation benefit, so check with your plan.
How much notice do you need for a non-emergency ride?
At least three hours for same-day requests and discharges. Booking 24 hours ahead guarantees availability.
Book the right ride
If the person is stable and needs help getting to an appointment, home from the hospital or to a new facility, book online through our reservations page or call (703) 304-7889. Tell us whether they walk with help, use a wheelchair or need to lie flat, and we’ll send an ambulatory, wheelchair, stretcher or bariatric crew to match. For anything urgent, call 911.
