Physician Request Non-Emergency Transportation Request Form
Cab transportation is reserved for individuals with a current significant condition or physical limitation that precludes them from riding the bus or using another form of transportation generally available to them such as a car.
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It is not meant to be used purely as a convenience for the member. Monroe Plan for Medical Care directly pays for this service. In order for Monroe Plan to provide transportation services to a patient or client, the company must have a current medical form on file and applicants must fill out the Physician Request Non-Emergency Transportation Request Form app. Applicants must provide functional limitation(s) that prevent the patient's use of public transportation, type of medical transportation requested, and a certification statement to prove medical necessity.
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