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.
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- Mandatory and optional benefits
- Behavioral health benefits
- Non-emergency medical transportation
- Cost sharing and premiums
- Alternative benefit plans
- Home- and community-based services
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Federal Requirements and State Options: Benefits
States have broad flexibility to create a benefit package for their Medicaid enrollees within federal guidelines. Certain benefits are mandatory—for example, inpatient and hospital outpatient services and services at rural health clinics and federally qualified health centers (FQHCs). Other services such as adult dental care, eyeglasses, and personal care services may be offered at the […]
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State Policies for Behavioral Health Services Covered under the State Plan
All state Medicaid programs offer certain mandatory behavioral health services such as medically necessary inpatient hospital services, outpatient hospital services, rural health clinic services, nursing facility services, home health services, and physician services. States may also choose to provide coverage for additional optional services under state plan authority, most commonly under the so-called rehab option […]
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Coverage of Medicaid Dental Benefits for Adults
Oral health problems affect a majority of Americans and poor oral health disproportionately affects adults living in poverty. Chapter 2 of the June 2015 Report to Congress on Medicaid and CHIP examines dental benefits for adults enrolled in Medicaid. Most low-income adults, when they have dental coverage, receive it through Medicaid but federal law does […]
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