NEMT vs. RTD Access-a-Ride: What Denver Patients Need to Know

If you or someone you care for cannot use Denver's fixed-route buses or light rail, two services come up repeatedly: RTD Access-a-Ride and non-emergency medical transportation (NEMT). Both provide rides for people with disabilities and medical needs. But they are designed for different situations, have different eligibility requirements, and work very differently in practice.

This guide breaks down the key differences so patients, caregivers, and case managers can make an informed choice — and understand when one service is the right fit and when the other is.

What Is RTD Access-a-Ride?

RTD Access-a-Ride is Denver's ADA paratransit service, operated by the Regional Transportation District. Under the Americans with Disabilities Act, any transit agency that operates fixed-route service is required to provide complementary paratransit service for riders who cannot use that fixed-route service due to a disability.

Access-a-Ride is a general-purpose transportation service — it can take riders to work, grocery stores, social appointments, medical appointments, or anywhere else within the RTD service area. It is not limited to medical trips.

Key facts about Access-a-Ride:

Eligibility is based on functional disability, not income or insurance status

Riders must apply and be certified as ADA paratransit-eligible

Service area mirrors RTD's fixed-route network (generally within ¾ mile of a bus or rail line)

Rides must be scheduled in advance (typically 1–2 days ahead)

Fares are set at twice the base fixed-route fare (currently around $5.50 per trip)

Shared-ride service — you may share the vehicle with other passengers

What Is NEMT?

Non-emergency medical transportation (NEMT) is a Medicaid benefit that covers rides to and from medical appointments for eligible members who have no other means of transportation. In Colorado, NEMT is administered through Health First Colorado (Colorado Medicaid).

NEMT is a medical benefit — it is specifically for healthcare-related trips, not general transportation. The ride is billed directly to Medicaid, meaning eligible patients pay nothing out of pocket.

Key facts about NEMT:

Eligibility is based on Medicaid enrollment and medical necessity

No separate application process — eligibility flows from Medicaid enrollment

Covers rides to any covered medical appointment (primary care, specialists, dialysis, therapy, etc.)

Can be scheduled same-day in some cases, though advance scheduling is preferred

No cost to the patient (billed directly to Medicaid)

Private vehicle service — not shared-ride

Covers wheelchair-accessible and stretcher transport for patients who need it

Side-by-Side Comparison

RTD Access-a-RideNEMT

Who qualifiesPeople with disabilities who cannot use fixed-route transitMedicaid members with no other transportation option Trip purposeAny purposeMedical appointments only Cost to rider~$5.50 per tripFree (billed to Medicaid) Service areaWithin RTD's fixed-route networkDenver metro and beyond Scheduling1–2 days in advanceAdvance preferred; same-day possible Vehicle typeShared-ride van or sedanPrivate vehicle, wheelchair-accessible, stretcher Eligibility processADA certification application requiredFlows from Medicaid enrollment Medicare coverageNoSome Medicare Advantage plans include NEMT

When Access-a-Ride Is the Right Choice

Access-a-Ride makes sense when:

You need transportation for non-medical purposes — work, shopping, social activities, community events

You are not on Medicaid but have a qualifying disability

You live within the RTD service area and your destination is also within that area

Cost is manageable — the ~$5.50 fare is affordable for your situation

You can plan ahead and schedule rides 1–2 days in advance

Access-a-Ride is a valuable service for Denver residents with disabilities who need general-purpose transportation. It is not designed for the specific demands of medical transportation — particularly for patients with complex needs or frequent appointments.

When NEMT Is the Right Choice

NEMT is typically the better option when:

You are on Medicaid and need rides to medical appointments

Cost is a barrier — NEMT is free for eligible patients

You need wheelchair-accessible or stretcher transport — NEMT providers are equipped for complex mobility needs

You are a dialysis patient requiring rides three times per week on a precise schedule

Your destination is outside the RTD service area — NEMT coverage is not limited to the transit network

You need a private vehicle rather than a shared-ride service

You are being discharged from a hospital and need a coordinated, reliable ride home

For dialysis patients in particular, NEMT is almost always the appropriate service. Dialysis requires rides three times per week, often at early morning hours, and the schedule must coordinate precisely with the treatment center. NEMT providers who specialize in dialysis transport — and who have existing relationships with DaVita and Fresenius facilities in Denver — handle this coordination far more reliably than a general paratransit service.

Common Misconceptions

"I have to use Access-a-Ride because I'm in a wheelchair."

Not necessarily. If you are on Medicaid, NEMT covers wheelchair-accessible transport to medical appointments at no cost. Access-a-Ride is one option, but it is not the only one — and for medical trips, NEMT is often more appropriate.

"NEMT is only for people who are very sick."

NEMT covers any covered medical appointment — primary care visits, specialist appointments, physical therapy, mental health appointments, and more. You do not need to be in a medical crisis to qualify.

"I can use Access-a-Ride for my dialysis appointments."

You can, but it may not be the best fit. Access-a-Ride is a shared-ride service with scheduling constraints that can make it difficult to coordinate with dialysis center schedules. NEMT providers who specialize in dialysis transport offer more reliable, coordinated service for this specific need.

"NEMT is hard to access."

For Medicaid members, NEMT eligibility is automatic — there is no separate application. The process is to contact a NEMT provider, confirm your Medicaid enrollment, and schedule your ride. A good provider will handle the billing verification for you.

What About Medicare?

Original Medicare (Parts A and B) does not cover NEMT. However, many Medicare Advantage plans (Part C) include transportation benefits as a supplemental benefit. If you have Medicare Advantage, check your plan's Evidence of Coverage document or call your plan's member services line to confirm whether transportation is included and what the coverage terms are.

If you have both Medicare and Medicaid (dual-eligible), your Medicaid NEMT benefit applies regardless of your Medicare coverage.

How to Access NEMT in Denver

If you are on Medicaid and need transportation to a medical appointment, the process is straightforward:

Contact a NEMT provider — call and confirm they accept Health First Colorado (Colorado Medicaid)

Provide your Medicaid ID — the provider will verify your eligibility

Schedule your ride — provide your pickup address, destination, appointment time, and any mobility equipment needs

Confirm the day before — a good provider will send a reminder and confirm the pickup time

For recurring appointments like dialysis, most NEMT providers can set up a standing schedule so you do not need to call for every individual ride.

Choosing the Right Service for Your Situation

The right choice depends on your specific needs:

General transportation + disability → Access-a-Ride

Medical appointments + Medicaid → NEMT

Dialysis + Medicaid → NEMT with a dialysis-specialized provider

Hospital discharge → NEMT or private medical transport

Medicare Advantage → Check your plan for transportation benefits

If you are unsure which service applies to your situation, a case manager at a Denver-area senior organization, disability advocacy group, or your healthcare provider's social work department can help you navigate the options.

Getting Help With NEMT in Denver

D.I.A. Medical Transportation provides NEMT services across the Denver metro area — wheelchair-accessible vans, stretcher transport, ambulatory rides, and airport medical transfers. We bill Medicaid and Medicare directly and coordinate with dialysis centers throughout the metro.

If you or a family member needs NEMT, or if your organization refers clients who need transportation assistance, we'd welcome the conversation. Learn more about our partnership program or call us at 720-210-0058.

We also maintain a free NEMT Resource Hub listing 40+ Denver-area organizations — hospitals, senior services, disability advocacy groups, dialysis centers, and mobility programs — to help patients and caregivers navigate the full range of available support.