Medicaid Benefits Database

Fromm KFF: For More Info, Go Here…

Federal Medicaid rules allow states flexibility to design their own benefit packages beyond meeting core federal requirements. These requirements specify certain mandatory services that each state’s Medicaid program must provide, that the services be adequate in amount, duration and scope, and that coverage not vary according to an individual’s diagnosis or condition. Beyond these minimum requirements, states have discretion in choosing which services to offer and the scope and range of the services. A list of mandatory and optional benefits is available here, and federal definitions of these benefits are available here.

The Kaiser Family Foundation (KFF) contracted with Health Management Associates (HMA) to survey Medicaid directors in all 50 states and the District of Columbia to identify those benefits covered for adult beneficiaries in their programs. The resulting data collection updates previous years of KFF Medicaid benefits data (data from 2012 and previous years remain accessible through drop down menus in most of the indicators below). The survey instrument was designed to capture information about benefits covered, cost sharing requirements, and notable limits on those benefits as of July 1, 2018. The 2018 survey asked states to report coverage of benefits in their fee-for-service (FFS) programs for categorically needy (CN) traditional Medicaid adults ages 21 and older. Unlike in previous years, the 2018 survey did not ask about benefit coverage for medically needy (MN) coverage groups. All but four states (Illinois, Iowa, New York, and South Carolina) submitted survey responses, and the territories are not included in the 2018 data. For additional notes and methods information and a summary table with national counts of states covering each benefit, click here. For data on Medicaid coverage of a range of behavioral health services by state, see the Medicaid Behavioral Health Services Database.

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