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What does Medicaid cover?

The benefits covered for adults through Medicaid are different in each state, but certain benefits are covered in every Medicaid program.

Doctor’s services that are covered by Medicaid include:

  • Laboratory and X-ray services
  • Inpatient hospital services
  • Outpatient hospital services
  • Health screenings for children and treatment if medical problems are identified
  • Comprehensive dental and vision services for children
  • Family planning services and supplies
  • Long-term care services and supports
  • Medical and surgical dental services for adults
  • Pediatric and family nurse practitioner services
  • Services provided in health clinics
  • Nurse-midwife services
  • Nursing facility services for adults
  • Home health care services for certain people
  • Prescription drugs

Other benefits your state must cover for children and may cover for adults:

  • Physical, occupational, or speech therapy
  • Eye doctor visits, eyeglasses
  • Audiology, hearing aids
  • Prosthetic devices
  • Mental health services
  • Respite and other in-home long-term care
  • Case management
  • Personal care services
  • Hospice services

The Affordable Care Act will expand options for community-based care. There will be more opportunities for people of all ages who have a disability to get help with daily activities while remaining in their homes. The Medicaid program continues to move toward providing more community-based care options as an alternative to nursing homes.

6 Responses to What does Medicaid cover?

  1. I have been applying for medicaid more then once. I have not received it yet. I have medical problems and I can’t even get help. I have worked in this state since I was 15 yrs. old. I need my medication. This is not right!

  2. I know it must be difficult for you. Please follow up with your local medicaid office with your application. You may need to visit in person to get the status on your application.

    Keep in mind:

    If your state is not expanding Medicaid and you can’t afford a health plan you can get low-cost health care at a Community Health Center near you.

    Health Resources and Services Administration (HRSA) health centers provide low cost health care through county clinics. Even if you have no health insurance or can’t get Medicaid you only pay what you can afford, based on your income.

    HRSA Health centers provide services such as:

    Wellness checkups.
    Diagnostic and treatment when you’re sick
    Pregnancy care
    Children immunizations and checkups
    Prescription drugs and dental care
    Substance abuse care and mental health services
    HRSA are federally-funded health service centers that provide care for you, even if you have no health insurance or cannot get medicaid. Remember, you only pay what you can afford, based on your income.

    Find a HRSA Health Center near you.

  3. Individual states administrate their own Medicaid program. You will need to call your local Medicaid office to speak with a counselor regarding coverage for rehalf “rehab” service. You can also visit your state social Service website to see if your state medicaid program provide coverage for rehalf “rehab” service.

  4. i am on total Disability and I thought I would be able to get insurance for me and my husband It is too expensive for us and now they are saying that they will ask for 12.75% increase. I will not be able to afford it. Someone from your office called me but, I declined either from pride or thinking I could afford the insurance. I need to come talk to someone about getting Medicaid. I can’t pay 200.00 for an office visit. I am a diabetic and have had a heart attack. If you will contact me thru my email I would appreciate it. Thanks.

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