What You Need to Know About Medicaid Benefits

May 7th 2016

Medicaid coverage has enabled low-income individuals and families to receive necessary medical and preventative care throughout the United States. Although benefits may vary from one state to the next, each state provides a comprehensive program that ensures health needs are met.

Mandatory Benefits

The federal government has set general guidelines for mandatory benefits that all states must provide for people who qualify for Medicaid. These benefits include inpatient and outpatient hospital services, early screening, diagnostic and treatment services, and physician services. In addition, people with Medicaid coverage are provided with nursing facilities and home health services, x-ray and laboratory services, and family planning assistance. In all states, Medicaid eligible patients can access certified pediatric and family nurse practitioner services, nurse midwife and birth center services, and, in many cases, assistance with transportation to medical facilities if needed.

Optional Benefits

Some states may offer additional benefits beyond those required by the federal government. Optional benefits may include hospice and private duty nurse care, dental and denture services, speech, hearing and language disorder care, occupational and physical therapy, and coverage for prescription drugs. In some states, respiratory care services, vision coverage and inpatient psychiatric care may also be covered by Medicaid.


Medicaid eligibility requirements vary by state, but in most cases, individuals must be a permanent resident or U.S. citizen in need of health care assistance with an income classification that is considered to be low according to state income standards. Women who are pregnant or have a child with a disability are often covered under Medicaid.

The Affordable Care Act of 2010 raised the Medicaid minimum eligibility level to 133 percent of the federal poverty level for eligible residents under 65. As of 2011, a family of four was considered to be at the poverty level with an annual income of $29,700 or less.

Application Process

To apply for Medicaid, individuals and families should submit an application in person at a Medicaid office or Department of Health and Human Services location within the state in which they reside. Many states also offer online applications online to make the process of applying more efficient and convenient. When applying, residents must provide proof of income, proof of identity, and information about dependents and other people living in their homes.


The Medicaid program supported by states provides low-income individuals and families with medical benefits when medical insurance is inadequate or non-existent. Medicaid programs are regulated by the federal government general guidelines, although benefits may vary by state. People interested in Medicaid coverage must apply within their respective states to determine eligibility.

More in category

Related Content