Louisiana Healthcare Connections

Gas Reimbursment

Louisiana Healthcare Connections has partnered with Veyo to provide our members with another way to get to and from medical appointments – with the help of a friend or family member. Veyo provides compensation to drivers who give Louisiana Healthcare Connections members a ride to their eligible medical appointments. This is called “gas reimbursement.”

Trips are paid at $0.56 per mile. The total amount paid is calculated based on the most direct route from the member’s pickup location to the medical facility and back. The distance is calculated using Google Maps. Payments to drivers will be sent electronically, unless the driver chooses a different payment option.

How does Gas Reimbursement work?


The driver must register with Louisiana Healthcare Connections/Veyo. You must submit a Driver Registration form before asking for reimbursement.


To be reimbursed for a trip, transportation needs to be scheduled with Veyo at least two business days before the member’s appointment. Please call 1-855-369-3723 (TTY: 711), Monday through Friday, from 7 a.m. to 7 p.m. to schedule a trip.

Take the Form with You to Your Appointment

Print out and take the Gas Reimbursement Form with you to your appointment. Ask your provider to sign/stamp the form. The form can be accessed using the link below.


Fill out and return the Gas Reimbursement Form to Veyo. This must be done within 365 days of your trip. Don’t forget to attach all parking and toll receipts. Forms that are missing information will be denied.

Frequently Asked Questions

Who can receive mileage reimbursement?

Friends or family of Louisiana Healthcare Connections members who do not live at the same address as the member may be able to get gas reimbursement.

To qualify:

  • The driver must have a valid driver’s license.
  • The driver must be listed on the vehicle’s insurance.
  • The driver must live at a separate address from the member. Gas reimbursement will not be paid to drivers who live at the same address of the member.
  • The driver must follow all public laws, ordinances, and regulations that apply to drivers and the vehicle being used.
  • The driver can register to drive up to 5 different Louisiana Healthcare Connections members. These members must be listed on the driver’s registration form.
  • The Louisiana Healthcare Connections member must be in the vehicle for the trip.

Can members get reimbursement for driving themselves to appointments?

No, Louisiana Healthcare Connections members can not be reimbursed for driving themselves to medical appointments.

What are the requirements for a trip to be reimbursed?

  • Transportation for the member needs to be scheduled at least two business days before the Member’s healthcare appointment. This will help ensure the driver is eligible. Call 1-855-369-3723 (TTY: 711) to book an appointment.
  • The driver must fill out the Driver Registration form before the trip.
  • The driver must live at a separate address from the member. Gas reimbursement will not be paid to drivers who live at the same address of the member.
  • The member must be enrolled with Louisiana Healthcare Connections on the date of the trip.
  • Only one fee per trip will be paid, regardless of the number of members transported.
  • If a member gets a prescription from the health care provider, they should stop and pick it up on the way home from their appointment. This will be counted as one trip.
  • A medical provider must verify that the member attended the scheduled appointment. The medical provider must sign/stamp and print their name on the Gas Reimbursement Form.
  • The Gas Reimbursement Form must be fully completed, and all parking and toll receipts attached. The reimbursement form can be found here on the Print Forms page. Forms that are missing information will be denied.

How do I sign up as a driver?

To sign up as a driver, the following information must be submitted using the Driver Registration form:

  • Full name of driver
  • Physical address of driver (must match the driver’s license and cannot be a PO Box)
  • The driver’s contact information, including email and phone
  • The social security number of the driver
  • A list of the Louisiana Healthcare Connections members they are looking to drive (no more than 5)
  • A copy of your current and valid driver’s license
  • Vehicle information, including the VIN and license plate number
  • A copy of your current and valid vehicle insurance card
  • A copy of your vehicle registration
  • The driver’s bank information for payment

Does the driver need to own their vehicle?

No, the driver does not need to own the vehicle. But the driver does need to provide a copy of valid vehicle insurance and vehicle registration.

What do I do if the driver’s information changes?

Please re-submit the Driver Registration Form to update a driver’s:

  • Contact information
  • Driver’s license
  • Vehicle information
  • Vehicle insurance
  • Vehicle registration
  • Banking information
  • List of members they will be driving

The new information will be automatically updated on the driver’s profile.

Do I need my medical provider to sign the Gas Reimbursement form?

Yes, each date of service must have a medical provider signature/stamp in order for reimbursement to be approved. Each trip will be confirmed with the provider’s office before payments will be made.

When should the forms be submitted?

  • The Driver Registration form can be sent in any time before the member books his or her trip. Trips need to be booked two business days before the member’s appointment. If the Driver Registration form has not been sent in at the time of the member’s appointment, a Veyo representative will try to reach out to the driver to get the missing information.
  • The Gas Reimbursement form needs to be filled out and returned to Veyo within 365 days of your trip. Don’t forget to attach all parking and toll receipts.

How do I submit the forms?

The completed driver registration and gas reimbursement forms can be sent to Veyo via email, fax, or mail. Don’t forget to include copies of the driver and vehicle documents. This must be done within 365 days of your trip. Forms can be submitted by:

  • Email: mrb@veyo.com
  • Fax: 1-855-667-2557
  • Mail: MTM Inc. – Veyo, Attn: Gas Reimbursement, 16 Hawk Ridge Dr., Lake Saint Louis, MO 63367

When will the reimbursement payment be sent out?

Approved trips will be paid out within these time frames:

  • Electronic payments: 1-2 weeks.
  • Payments via paper check: 4-6 weeks. Paper checks are mailed out on the last day of each month.