Children receive the most Medicaid benefits.
Medicaid is the largest insurance program in the United States. Medicaid is offered to eligible low-income individuals and families that cannot otherwise afford health insurance. Medicaid sends payments for covered medical and dental services directly to health-care providers. Medicaid is a state-administered program, and states set the eligibility requirements for receiving benefits.
Medical Benefits
The medical benefits offered by Medicaid differ among states. However, every state offers some common benefits to Medicaid participants. They include preventive services, treatment of certain diseases, hospital inpatient and outpatient services, nursing home care, home health care, clinic services and prenatal care. Check with your local Medicaid office to get a full list of the medical services covered.
Dental Benefits
Dental benefits are optional coverage for individuals 21 and older, and are determined by states. Less than half of states provide comprehensive dental coverage for those 21 and older; however, most states provide emergency dental care. Individuals who are younger than 21 years old must receive dental care as part of their Medicaid coverage. Dental care for minors is a part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service. Dental services include oral examinations, relief of pain and infections, restoration of teeth, and dental maintenance.
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Medicaid offers the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service as a preventive child health-care program for children and those under the age of 21. EPSDT offers screening services such as laboratory tests and lead toxicity screening, along with immunizations. The EPSDT program includes at least minimum vision benefits such as diagnosis and treatment of basic vision ailments. Dental services, hearing services, and diagnosis and treatments are available in the EPSDT program.
Eligibility
Some individuals are automatically accepted into the Medicaid program. Individuals who receive Supplemental Security Income (SSI) automatically qualify to receive Medicaid. Babies born to mothers who receive Medicaid are automatically covered. Children under the age of 6 and pregnant women whose families earn 133% or below the national poverty level qualify to receive Medicaid. Recipients of foster care and adoption assistance are automatically eligible. States have discretion on who is eligible for mandatory benefits if they do not fit in the mandatory group.
Tags: Diagnostic Treatment, Diagnostic Treatment EPSDT, Early Periodic, Early Periodic Screening, Periodic Screening, Periodic Screening Diagnostic