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What Medicaid Covers

Services That States May Cover

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States have the option of covering additional services including:

  • Prescription coverage (which is provided in all states)
    • The following states limit the number of prescriptions: Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, NOrth Carolina, Oklahoma, South Carolina, Tennessee, Texas and West Virginia).
  • Second opinions
  • Optometrist services and eyeglasses.
    • Eye exams.
      • Must be covered in all states for children.
      • Are covered in most states.
    • Eyeglasses:
      • Must be covered in all states for children.
      • Are covered all states except Delaware, Kentucky, Louisiana, Mississippi and Tennessee.
      • The eyeglasses which are covered are the inexpensive variety. Contact lenses are generally not covered.
  • Transportation to and from a medical facility where medical care is provided, by ambulance if required. (Covered in all states except Maryland).
  • Physical therapy. (Covered in all states except  Colorado, Delaware, Louisiana, Missouri, North Carolina, Oklahoma, Pennsylvania, Rhode Island and Tennessee).
  • Prosthetic devices. (Covered in all states except North Carolina)
  • Dental services.
    • All states must cover children's dental care.
    • Most states do not cover adult dental care. Those that do genearlly restrict dental coverage. For example, basic dental care may be covered, but not orthodonture, root canal or crowns.
    • The private Doral Dental firm has listings of many (but not all) Medicaid- and SCHIP-participating dentists in many (but not all) states and localities. Call 800.417.7140 or go to www.doralusa.com offsite link
  • Dentures.
    • All states must cover children's dentures.
    • Most states cover adult dentures.
  • Funeral expenses.
  • Travel to and from the health care site.

There are other optional services that states may cover. Coverage varies widely from state to state. These optional services include chiropractic care, podiatry, preventive care, inpatient and outpatient rehabilatative center services, adult hearing aids, physical, speech and occupational therapy, and any other medical or rehabilitative servivce recognized and allowed under state law. 

To learn about the benefits in your state, see the Kaiser Family Foundation's web site:  www.kff.org/medicaid/benefits/index.jsp?CFID=19068006&CFTOKEN=10261818 offsite link  

If you need eyeglasses, a hearing aid or dental services and they're not covered in your state, see: Eyeglasses, Hearing Aids And Dental Services


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