Benefits
Medicaid covers routine health services as well as benefits that are limited or not typically covered under other health insurance plans such as long-term services and supports, translation assistance, and non-emergency transportation services that are important to low-income seniors, adults with disabilities, and children with special health care needs. There are also specific rules affecting use of cost sharing and premiums. Learn more about Medicaid benefits.
Learn More about These Topics
- Mandatory and optional benefits
- Behavioral health benefits
- EPSDT in Medicaid
- Non-emergency medical transportation
- Cost sharing and premiums
- Alternative benefit plans
Featured Publications
Pharmacy Benefit Managers and Medicaid
May 7, 2026
Pharmacy benefit managers (PBMs) have a central role in the drug distribution chain and serve as intermediaries in administering the prescription drug benefit on behalf of payers. In recent years, some policymakers and stakeholder groups have identified the role of PBMs in the Medicaid drug distribution chain as a potential driver of increased drug spending. This issue brief provides […]
State Medicaid Coverage of Assistive Technology for Adults Using Home- and Community-Based Services
April 21, 2026
Medicaid home- and community-based services (HCBS) programs are the primary vehicles for Medicaid coverage of assistive technology (AT) for adults. All states and the District of Columbia cover some AT in their HCBS programs serving adults, and the services covered vary. MACPAC conducted a scan of HCBS programs serving adults as of September 2025. Of […]
Mandatory and Optional Enrollees and Services in Medicaid
March 30, 2026
Federal statute and regulations mandate the coverage of certain populations and benefits in Medicaid and define the optional populations and services states may cover. States make policy decisions regarding their program’s parameters within these federal requirements to meet their specific needs and priorities. This issue brief describes the mandatory and optional eligibility pathways in Medicaid […]