Medicaid Mileage Reimbursement Form 2024

Medicaid Mileage Reimbursement Form 2024. A2c will mail the mileage reimbursement policy, the mileage reimbursement trip log and a claim form prior to the member’s first medical appointment. Allowances for meals and lodging are also a set amount.

View or download the mileage reimbursement instructions and trip log/claim form. Mail or fax download and submit a mileage reimbursement form within 90 days after your ride.