NEMT riders without a cell phone: reminders, will-call returns, and pickups without texting

Most riders get a text the day before and a tracking link when the van is close. Some riders get neither, because they have a landline, a basic phone that will not open links, a phone that is out of minutes, or no phone at all. Many of them are older, live on low incomes, or both.

These riders are not hard to serve. They need a different plan at three points: the reminder, the ride home from a will-call, and the minutes at the door when the driver cannot reach them.

How many riders lack a smartphone

Almost every adult owns some kind of cellphone, but smartphones drop off with age and income. Pew Research Center’s 2025 survey found 98 percent of U.S. adults own a cellphone and 91 percent own a smartphone. The gap is widest among older and lower-income adults.

A basic cellphone can usually take a call and often a text, but it cannot open a tracking link. Pew also found 95 percent of adults 65 and older own a cellphone of any kind.

Landlines hang on with the oldest riders. CDC’s National Health Interview Survey for July to December 2024 found that among adults 65 and older, 8.0 percent have both kinds of phone but take all or almost all calls on the landline, and 4.3 percent use a landline only. Across all adults, 1.0 percent had no phone service. That share rose to 1.7 percent outside metro areas and 2.6 percent among adults in families below the poverty line.

Where you run matters too. CDC’s modeled state estimates for 2024, released in September 2026, put the largest share of landline-only adults in West Virginia (4.1 percent) and Vermont (3.8 percent), followed by Hawaii and New York (3.1 percent each) and Maine (3.0 percent). West Virginia and South Dakota had the largest shares of adults with no phone, 1.9 percent each.

Get the right contact details at booking

The fix starts with the rider profile. Ask these questions once, and update them whenever a ride goes wrong:

1. What kind of phone? Landline, basic cellphone, smartphone, or none. Text and link reminders only work for some of these.
2. Whose phone is it? A shared family phone or a neighbor’s number needs a name attached.
3. What time of day works for a call? Some riders keep the phone off or are out at day programs.
4. Who else can we reach? A caregiver, a relative, a building manager, or the nursing station at the rider’s facility. Get the rider’s agreement to call them. HIPAA allows sharing the details that matter to a relative’s or friend’s role in the rider’s care, generally with the rider’s agreement (45 CFR 164.510(b)).
5. What happens at the door? Which entrance, whether the rider hears the bell, and whether the driver should knock loudly or wait at the curb.

The free rider profile form has room for these.

Brokers care about the contact on file too. Modivcare’s MaineCare rider no-show policy says that when staff cannot reach a member by phone or mail, they may ask facility staff for updated contact details, and a member who has not kept those details current is not excused from the policy. Pass any new number you learn to the broker.

Phone type can also change how a trip is assigned. Missouri’s NEMT FAQ says a member needs to send and receive texts to ride with a rideshare company, and a member who cannot should call the broker at (866) 269-5927 to have rideshare taken off their file.

Reminders without texting

A live call from dispatch the day before is the backbone. Keep it short: the pickup time, the place, and the number to call to cancel. If a machine answers, leave the time and your company name and leave out the appointment.

• Call the morning of for early pickups and for riders who have missed rides before.
• Call the caregiver instead of, or as well as, the rider when the rider has agreed to it.
• Hand over a printed card at the first ride with the standing pickup times and your office number. A rider without a phone can still show it to the clinic front desk.

Automated calls are a separate decision. Prerecorded reminder calls to a home phone fall under the federal TCPA’s call caps and opt-out rules (47 CFR 64.1200(a)(3)). A dispatcher dialing by hand and speaking live is outside them. Our guide to ride reminders and tracking links covers consent, call caps, and opt-outs before you set up any automated calls.

Help the rider get a phone

Lifeline is the federal program that discounts phone or internet service for low-income households, and Medicaid qualifies a household for it (47 CFR 54.409). The other qualifying programs are SNAP, Supplemental Security Income, Federal Public Housing Assistance, and the Veterans and Survivors Pension. A household can also qualify by income at or below 135 percent of the federal poverty guidelines, which USAC lists as $21,546 for one person in the 48 contiguous states for 2026.

The federal discount is up to $9.25 a month (47 CFR 54.403), with up to $25 a month more for residents of Tribal lands. Only one Lifeline benefit is allowed per household. A plain landline with no internet is a harder fit: since December 1, 2021, voice-only service gets Lifeline support only from a provider that is the only Lifeline provider in its Census block, and then $5.25 a month. Riders apply through USAC’s National Verifier or through a phone company that offers Lifeline.

Your role is to point the way. Tell the rider or their case manager that Lifeline exists and that Medicaid qualifies them. Leave the application to them.

Will-call returns through the front desk

A will-call return waits for word that the rider is ready. For a rider without a phone, someone else has to send that word. In CareOregon’s provider manual, for one, a will-call has no pickup time until the member, or someone on the member’s behalf, calls the brokerage to say the member is ready. The clock starts with that call. MTM Health’s handbooks for Virginia and Rhode Island both give the van 45 minutes from notification. In Modivcare’s Mississippi manual, the member calls the broker’s Ride Assist line, the agent passes the word to the provider, and the pickup must come no more than 45 minutes after the member’s call.

Make the clinic part of the plan:

1. At drop-off, tell the front desk the rider has a will-call return and hand over a card with the broker’s ride line, or your number for private-pay trips, plus the trip number.
2. Ask staff to call when the rider is done, not when the appointment starts.
3. Ask for a timed return instead when the clinic can tell you how long the visit runs, such as a set-length infusion or therapy session.
4. Check in yourself if a will-call has been open far longer than the visit should take. Call the clinic, not the rider.

Holding capacity for these returns is covered in the will-call trips guide.

At the door when you cannot reach the rider

Broker door rules assume the driver can call or text. MTM’s Rhode Island handbook has the driver call or text the member to say the van is outside or will be leaving. Its Virginia handbook asks drivers to make reasonable phone or text attempts to reach the member before departing. For a rider with no cellphone, the same effort takes a different shape:

1. Knock or ring, and call out the company name.
2. Have dispatch call the landline. A landline rings inside where the rider can hear it, even when a knock does not carry.
3. Have dispatch call each contact on file, starting with the one most likely to be with the rider.
4. Ask building staff, such as a front desk or a manager, whether the rider has left.
5. Stay for the full required wait. CareOregon’s manual sets the minimum wait at a quarter hour past the scheduled pickup, and drivers may not leave a no-show without telling dispatch.
6. Record every attempt with the time and the number called.

When something looks wrong, such as a rider who never misses dialysis not answering, dispatch should call the emergency contact, and 911 if there are signs the rider needs help. The full door procedure and the reporting steps are in our guide to reducing no-shows.

Running these trips in HealthRide

In HealthRide, a will-call return holds a place on the schedule, and when word comes that the passenger is ready, one tap sets the real pickup time and gets the driver moving. Riders who do text get reminders before the ride and when the driver is on the way. See recurring trips.