What Medicaid Covers

As you might imagine with respect to a plan that is administered by the state where you live, there can be problems with obtaining medical care outside the state. Each state has its own rules about out-of-state medical treatment, so check with your own state's Medicaid administrator before traveling out-of-state.

Generally, only the following are covered in another state:

• Charges related to a life-threatening emergency.
• Charges incurred when your health would be endangered in the absence of immediate medical care -- if a provider agrees to your state's provider enrollment contract.
• Charges pre-approved by Medicaid, such as treatment at a specialized out-of-state clinic.
• Charges along state borders where residents routinely seek treatment across the state line and for which Medicaid has made arrangements to cover this care.

Out-of-country coverage is never covered.

Edited by Thomas P. McCormack
Editor, Medicaid Watch and Independent Consultant
Washington, D.C.

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