The primary purpose of Medicaid is to provide low income health care, with a focus on preventive care. Since each state has its own Medicaid policies, both the costs and the coverage can differ between states and U.S. territories.
However, there are certain mandatory benefits required by all states and U.S. territories. The federal government requires all Medicaid agencies to provide the following mandatory benefits:
- Services at hospitals and healthcare facilities
- Inpatient hospital visits
- Outpatient hospital visits
- Nursing facility services
- General health and diagnostic services
- Home health services
- Physician services
- Rural health clinic services
- Federally qualified health center services
- Lab and X-ray services
- Early and periodic screening, diagnostic and treatment (EPSDT) services for infants and toddlers
- Medical transportation
- Women’s health services
- Family planning services
- Nurse midwife services
- Certified pediatric and family nurse practitioner services
- Freestanding birth center services, when state-approved
- Tobacco cessation counseling services for pregnant women
Some states and territories may also provide other benefits, such as dental and vision insurance. In addition to Medicaid dental insurance and vision insurance plans, they may offer prescription drug coverage, therapy, hospice care, and other benefits. You can check with your state’s Medicaid office to find out what the Medicaid benefits are where you live.
If you’re looking for free healthcare, you might be able to get it through Medicaid. It depends on where you live as well as your income. However, just because you meet the income qualifications for Medicaid in your state, it might not be low enough to qualify for free coverage.
Some states charge Medicaid recipients a monthly premium. In California, for example, some families enrolled in the Medi-Cal Medicaid program pay a monthly premium of $13 per child up to a maximum of $39 per month. However, even in these states, some individuals are exempt from paying premiums.
In addition to monthly premiums, some states require Medicaid members to pay copayments when they receive medical services. These copayment amounts are typically very low so that they do not prevent people from getting the medical services that they need. For example, in Alaska, it costs a Medicaid member $3 to visit a doctor or clinic.
Medicaid premiums are still drastically lower than premiums for other plans. For example, if you were to get other health insurance coverage, such as enrolling in a plan through the Affordable Care Act (ACA), your monthly premium could cost between $328 and $482 per month. Copays for Affordable Care Act insurance vary by state and provider, but are typically between $15 and $30 for a visit to your doctor.