With over 63 million people using it, Medicaid covers many low-income families in America. Since it is paid for by state and federal tax, this government-based health insurance has no premiums and is available to anyone in the U.S., as long as they make below the income threshold. While this insurance program is nationwide, insurance is still a state-managed affair, thus coverage varies from state to state. There are, however, coverage requirements all Medicaid plans include. Here are a few:
Doctors And Specialists
Under Medicaid, a primary care physician is always covered, since policyholders are given the option to choose their doctor upon enrollment. While not all doctors accept Medicaid, there are numerous doctors who do, and you can always ask your insurance provider for a list of local doctors who accept Medicaid. Alongside primary care, inpatient and outpatient hospital visits, laboratory work, medical transportation, and midwife services are all covered under Medicaid as well.
Since states can decide what additional areas may be covered under their specific plan, state Medicaid providers will often include areas of coverage deemed “optional” by the national government. Optional coverage includes physical therapy, speech therapies, chiropractic services, dental and vision care, respiratory care, prosthetics, and prescription medications. Since these services are optional, their coverage varies from state to state. In this case, always ask your primary care physician and your Medicaid provider what services are covered when discussing therapies, new medications, or other medical decisions.
Even though prescription medications are an optional part of Medicaid coverage, most states have prescription drugs on their list of covered expenses. Medicines are expensive! Products like insulin that are required to keep people alive are usually covered, but when it comes to painkillers, mental health drugs, and other medicine, certain brands and types of medication may not be covered; it is up to the state’s discretion. As always, it is important to speak with the doctor who prescribes the medications if you have any concerns about coverage. Typically, doctors will take their patient’s insurance into account when prescribing drugs. Pharmacists can also work with doctors and Medicaid providers to stock an approved brand of medication, and they are able to answer questions at the counter if prescription users have a copay or a deductible fee and don’t know why.
Just like medications, home medical supplies are an optional addition to Medicaid. While items like wheelchairs and oxygen tanks are often covered, it is once again up to the state Medicaid provider’s discretion to determine what is and isn’t covered. Medical supplies, however, can be prescribed by a doctor to help reduce their cost, by deeming an item as “necessary” to the insurance company.
Medical supply coverage extends to online purchases as well, making discreet shipment accessible to customers all around the country. To qualify for coverage, suppliers will ask the customer to fill out a form on the website so that they can legally bill the insurance company. In cases where the supplier reimburses customers instead of billing the insurance agency, a form will be needed alongside proof of purchase. Policyholders should always discuss medical supply purchases with their Medicaid providers to get the best item they can for the lowest price.
If you are a Medicaid recipient looking to purchase medical supplies, visit Medical Supply Depot.