Medicaid

Medicaid may cover:

• Doctor visits and specialist care
• Hospital stays and emergency room visits
• Prescription medications
• Laboratory tests and X-rays
• Preventive care such as vaccinations and screenings
• Mental health and substance abuse treatment
• Dental care (for children and some adults)
• Vision care (including exams and glasses)
• Physical therapy and rehabilitation services
• Home health care and nursing home care (for eligible individuals)

It's important to note that specific coverage may vary depending on factors such as Medicaid plan type and individual eligibility. For precise details on covered services, beneficiaries should refer to their Medicaid plan documents or contact the Missouri or Kansas Medicaid program directly.

• Income Limits: Medicaid eligibility is often based on income, and there are specific income limits that applicants must meet to qualify. Those with incomes above these limits may not be eligible for Medicaid.

• Asset Limits: Some states impose asset limits, meaning applicants must have limited assets, such as savings or property, to qualify for Medicaid. Assets above the set limit may disqualify individuals from Medicaid eligibility.

• Citizenship or Immigration Status: In general, only U.S. citizens, nationals, or qualified immigrants are eligible for Medicaid. Undocumented immigrants typically do not qualify for Medicaid coverage.

• Specific Coverage Limitations: Medicaid may not cover certain medical services, procedures, or treatments deemed medically unnecessary or elective. Examples may include cosmetic surgery, fertility treatments, and some experimental treatments.

• Waiting Periods: Some states may impose waiting periods for Medicaid coverage, particularly for individuals who have recently moved to the state or who have become eligible due to changes in circumstances.

• Managed Care Restrictions: Medicaid recipients enrolled in managed care plans may face limitations on provider choice or coverage for out-of-network services. It's essential to understand the restrictions and coverage limitations of the specific managed care plan.

• Work Requirements: Certain states may impose work requirements for Medicaid eligibility, mandating that able-bodied adults meet specified work or community engagement activities to maintain coverage.

Applicants should check the rules and limits of their state's Medicaid program to make sure they understand what's covered and if there are any things that aren't covered. Also, getting help from Medicaid Reps or healthcare guides can clear up any questions about who qualifies and what's included.

Some believe that only unemployed people qualify for Medicaid, but many Medicaid recipients work, and just have low incomes. Some people also mistakenly think Medicaid only covers basic medical services, overlooking its coverage of essential healthcare services, including long-term care and mental health treatment. 

Another common myth is that Medicaid is only for adults, not knowing it also provides critical healthcare coverage for children, pregnant women, and those with disabilities.

Medicaid often works alongside other programs like Medicare or private insurance to provide comprehensive healthcare coverage. In cases where individuals are eligible for both Medicaid and Medicare, Medicaid may help cover Medicare premiums, deductibles, and other out-of-pocket costs. 

For those with private insurance, Medicaid may act as a secondary payer, covering costs not covered by private insurance or filling gaps in coverage, particularly for low-income individuals who may struggle to afford necessary medical care.

It is essential for nearly 2 million families between Missouri & Kansas in keeping their necessary medical expenses covered despite their financial situation. Over 1.4 million people in Missouri are enrolled in Medicaid and over 415,000 are enrolled in Kansas.