Millions of Americans today benefit from Medicaid. This healthcare program reduces health disparities by expanding access to low-income individuals. Continuity of coverage has improved thanks to this expansion. Individuals enrolled in Medicaid must know which benefits they are entitled to and which may be available. This information allows them to get the most from the coverage.
Mandatory Benefits
Many individuals look into applying for Medicaid benefits to have their doctors’ appointments covered and know they won’t have an expensive bill to pay if they are hospitalized. However, Medicaid covers many other services they may not be aware of. A person enrolled in this program can receive transportation to medical care, and enrollees are eligible for early and periodic screening, diagnostic, and treatment services.
Family planning services are included in Medicaid plans, and pregnant women can benefit from tobacco cessation counseling. People often wonder if they will be limited to certain types of care, but the program allows for options. A person might choose home health services or work with a nurse midwife rather than an obstetrician. Family nurse practitioners are covered under the program, and participants may use medication-assisted treatment services. Patients who want to participate in qualifying clinical trials will find routine costs are covered.
Optional Medicaid Benefits
Many plans offer additional Medicaid benefits. Licensed practitioner services might be covered along with private duty nurses. A person should ask if clinic and dental services are part of their plan. Individuals who need physical or occupational therapy should talk with their insurance provider to learn whether it pays for this care.
Medicaid programs may cover speech, hearing, and language services or other diagnostic, screening, preventative, and rehabilitative services. Prescription drugs are included with some plans, and a person might find their insurer will pay for their eyeglasses, dentures, or prosthetics. Inpatient psychiatric services are often covered for those 21 or younger, and the insurer might cover case management services. The insurer may cover personal care services and hospice benefits for patients needing those types of care.
Understanding Coverage
Every Medicaid applicant and enrollee should talk with their insurer regularly to understand which services will be paid for and which remain their responsibility. This information may change over time, and no one wants to learn they are responsible for a previously covered bill. Furthermore, people should monitor changes to federal law, as they may affect Medicaid services. The more information a person has, the easier it is to make the most of their coverage.
Applying for Medicaid
Individuals should contact their state Medicaid agency to learn what services are covered and the steps required to apply for the program. Each state varies regarding what it covers and how a person should apply. However, individuals will find these agencies helpful in answering questions and finding participants the insurance that best meets their needs.
Once a person applies for Medicaid and is accepted to the program, they must find providers that take this insurance. The insurer maintains a list of providers, so that is where a person should turn. Furthermore, the insurer can provide information about which services are covered.
People should always work with their insurer to confirm they have the latest information. Nobody wants to visit a provider believing the bill will be paid, only to learn it is their responsibility. The insurer will minimize this risk, so participants should reach out before any visit.