This page is displayed because you indicated a change, ending, or addition of medical transportation costs. The page will repeat for each member who was selected as having medical transportation costs. If this was indicated by mistake, remove the record once you reach the Other Bills Summary page.
Some items have an asterisk (*) next to them, indicating they are mandatory. You must fill in these items before you can continue to the next page.
Medical Transportation Costs
Depending on if you selected that an expense was added, changed, or ended, enter the date into the “When did this bill start,” “When did this bill change,” or “When did this bill end” fields.
Medical Transportation Cost Details
When entering How much does [Household Member] pay per trip? Only enter two decimal places. Special characters, such as commas, are not allowed.
Add Another?
To add another medical transportation cost, select Yes to the question, “Does [household member] have any other medical transportation costs?”
Click the Print button to print this page for your reference.
Click the Next button to save and continue with the online Redetermination/Change Report/Simplified Report.
Click the Previous button to view the previous page.
Click the Save & Exit button to exit the online Redetermination/Change Report/Simplified Report and save your progress on your Redetermination/Change Report/Simplified Report. The Redetermination/Change Report/Simplified Report is saved as Incomplete.