Medicaid is a largest health-related service provider for people with limited income and certain other eligible individuals, in the United States.
All states are directed by the Title XIX of the Social Security Act to provide mandatory coverage for specific services like inpatient and outpatient hospital services.However, the decision to cover optional services is the state’s prerogative. The services to be mandatorily covered by Medicaid can be broadly classified into five categories. They are discussed below:
- Inpatient hospital services: These services refer to the services provided to an inpatient in an approved hospital. These include but are not limited to bed, boarding, nursing services, utilization of hospital facilities like the medical equipment and appliances. This also includes transportation service by an ambulance.
- Outpatient hospital services: These include precautionary, diagnostic, curative, rehabilitative, or palliative services under the supervision of an approved physician or a dentist in the hospital. Minor surgeries, vaccinations for children, family planning services and renal dialysis are also part of these services.
- Skilled nursing-home services: This service is to be provided by Medicaid approved nursing homes and it includes home health care for eligible individuals.
- Physician services: These services include, but are not limited to pediatric and family general practitioner services, Nurse-midwife service.
- Laboratory and x-ray services
- Additionally, there are the optional Medicaid services that the states may choose to provide. The optional services are diagnostic, clinical services, intermediary care facilities for the mentally retarded (ICFs/MR), drugs, spectacles and physical therapy services.
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