What are the Different Types of Medicaid Benefits?

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  • Written By: Susan Grindstaff
  • Edited By: Heather Bailey
  • Last Modified Date: 04 May 2020
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Medicaid is a health care program for low-income families that is funded by both state and local governments inside the United States. Medicaid benefits often vary from state to state. Certain types of coverage are mandated and required to be offered in all states, while some are considered optional services and may not always be included. Some Medicaid benefits that are a part of required coverage include medical treatment resulting from sickness or accident, routine physical examinations, and prenatal care. Some medical services that are optional services include eye exams and prescription glasses, dental care, and prosthetics.

Medical treatment covered by Medicaid benefits includes doctor visits, emergency room treatment, and services provided by community health clinics. Services can be administered by a physician, a nurse practitioner, or a registered nurse. In most cases, covered visits must be related to sickness or preventive care. Preventive care includes routine physical examinations, medical screenings, and eye and dental check-ups.

Dental coverage is not considered mandatory coverage for all Medicaid recipients. Eligibility is often dependent on income level and the coverage policies of the specific state. Most states offer some type of dental care, but it is sometimes limited to checkups, and may not cover corrective or cosmetic dentistry. Corrective dentistry could include braces or retainers, and cosmetic dentistry could include implants, caps, and whitening.

In most states, Medicaid benefits include routine eye exams, but often will not include some services provided by an optometrist. There may be a cap on the amount of coverage available for eyeglass or contact lenses. In addition, ophthalmology coverage may only be available for yearly checkups or eye injuries.

Prenatal care and family planning are Medicaid benefits that are mandatory in all states. This includes all doctor visits and laboratory testing necessary to ensure the health of the mother and baby. For mothers who are addicted to tobacco, alcohol, or drugs, prenatal care includes treatment programs to help cure these addictions. Family planning generally includes counseling to explain responsibilities of parenthood and education and access to various types of birth control.

Weight loss programs are often covered by Medicaid because they are usually considered wellness programs. Studies generally indicate that obesity may be the causal factor behind many life-threatening conditions such as heart disease, high blood pressure, and diabetes. Lowering the incidence of obesity may eventually help lower costs for health care, which could lead to lowering the overall costs associated with Medicaid programs.

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