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Medicaid: How To Maximize Use

Find A Medicaid Provider Who Meets Your Criteria And Who Knows The Medicaid System

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Not every doctor or other medical provider accepts Medicaid patients. 

Every doctor, hospital, pharmacy, and other provider that does take Medicaid patients must have a prior agreement with Medicaid to do so. Part of the deal is the provider must  agree to accept a Medicaid payment as payment in full. The provider must also agree not to seek any further payment from the patient unless the Medicaid plan itself provides for co-pays. 

There was a time when it was difficult to find top quality providers who were willing to accept Medicaid because of the low fees that Medicaid pays. However, with the limitations imposed by managed care, Medicaid dollars are more competitive as is the quality of care.


Public and non-profit medical facilities are the ones most likely to work with Medicaid and accept Medicaid patients. Based on the area of the country you live in and the reimbursement rate paid by your state's Medicaid plan, there may be a lot of private doctors who accept Medicaid or there may be very few.


To locate providers who accept Medicaid:

  • Check with your worker at the Medicaid office. Some offices maintain lists of participating providers that you may access.
  • Ask your local disease specific nonprofit organization, members of your support group, and other people you know with your health condition.
  • Ask your current providers and other medical providers to whom you may have access.
  • Ask your pharmacist if they accept Medicaid. If they do, ask who the doctors are that are submitting Medicaid prescriptions to them, especially those who are familiar with your medical condition. 

When you choose a doctor:

  • First look at the suggestions in Choosing A Primary Care Doctor, Choosing A Specialist, Choosing A Doctor For A Second Opinion.
  • Determine that the doctor is a Medicaid participating provider.
  • Find out how much experience the doctor has with the Medicaid system. Just as you want a doctor who is very familiar with your particular medical condition, you also want to find a doctor who knows the Medicaid system. Medicaid can be a formidable bureaucracy. Your doctor needs to be able to work within the system to get you all the appropriate treatment.

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