Medicaid is a state-operated, federal-and-state-funded health insurance program for qualifying low-income individuals, including the elderly and disabled, pregnant women, and children. In some states, Medicaid also covers women with cervical or breast cancer, individuals with HIV/AIDS, refugees and other at-risk groups.
Dual Eligibility
Individuals with both Medicare and Medicaid may qualify for Qualified Medicare Beneficiary (QMB) or related programs. These programs offer recipients the benefit of paying their Medicare co-payments, co-insurance, deductibles and other out-of-pocket costs related to Medicare.
Dental Benefits
The Centers for Medicare and Medicaid services mandates that all state Medicaid programs must provide dental services to individuals under age 21. These programs must cover regular exams, X-rays, restoration of teeth and other essential services. States have the option to choose what level of dental coverage, if any, to provide to individuals 21 and over. Coverage of orthodontic braces varies among states.
Prescription Drugs
Medicaid offers coverage for most prescription drugs. However, if pill quantity or dosage limits are exceeded, a prior authorization will be required and the claim for coverage may be denied.
Mental Health
Medicaid provides comprehensive coverage for the mentally ill, including psychotropic medication management, individual, group and family therapy, case management, partial hospitalization services, inpatient and residential mental health and addictions treatment.
Elderly
Medicaid covers the cost of long-term care at nursing facilities, hospice care, in-home health services and other medical services for the elderly.
Medical Transportation
Emergency medical transportation is covered under all Medicaid programs. Non-emergency medical transportation coverage varies among states. Contact your local or state Medicaid office to determine the exact coverage.
General Medical Care
Medicaid provides coverage for a variety of inpatient and outpatient medical services, including annual checkups, services provided by specialists, physical therapy and more. Consult with your state's Medicaid program to obtain a more comprehensive listing of covered services.
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