Medicaid Services
Some states include the following services under Medicaid:
Services for women with specific ailments:
Women suffering from breast cancer or cervical cancer have limited-time eligibility to receive all plan services.
Services related to the treatment of TB are also available to those who are uninsured.
Long-term care:
Under Medicaid, all states provide community long-term care for individuals eligible for Medicaid who qualify for institutional care. The eligibility requirements for such individuals are generally more liberal.
Those categorized as needy are entitled to the following mandatory state services:
- inpatient hospitalization excluding hospitalization for mental disease
- outpatient services provided by Federally Qualified Health Centers (FQHCs) and others, such as rural health clinics, and ambulatory services included under states' plans
- laboratory tests and x-rays
- access to certified pediatric and family nurse practitioners
- family-planning services and supplies
- medical and surgical dental services
- physicians' services
- services provided by nursing facilities (for beneficiaries aged 21 and older)
- pregnancy and 60-days-postpartum pregnancy-related services
- prenatal and delivery services
- home health services
This program is for those children under age 20 whose parents are not eligible for Medicaid but cannot afford to buy private insurance.
Access to the State Children's Health Insurance Program (SCHIP) is available in each state. In some states, SCHIP is part of the Medicaid program; in others, it is a separate program; and in still others, it is a combination.
SCHIP includes free care for healthy babies and children, but for other services, premiums or co-payments must be paid depending on the parents' income.
There are gaps in the Medicaid program, and not all poor persons are eligible for services under Medicaid. The very poor are covered only if they are in one of the designated eligibility groups. Medicaid eligibility depends not only on low income but also on assets and resources that are measured against established thresholds.
States can choose to offer many more services under Medicaid beyond the mandatory services. Each of the states has a different Medicaid plan with different payment terms and services offered.
