What does Medicaid cover?

What does Medicaid cover?

The following services are covered by Medicaid (if they are not covered by Medicare or any other insurance and if the Maryland Medicaid Program's specific requirements are met for the services):

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  • Ambulance and wheelchair van services and emergency medical transportation
  • Ambulatory surgical center services
  • Clinic services
  • Dental services and dentures (for beneficiaries under 21)
  • Diabetes care services (covered under HealthChoice)
  • Early and periodic Screening, Diagnosis and Treatment (EpSDT) Services (for beneficiaries under 21)
  • Eye glasses (for beneficiaries under 21)
  • Family planning services and supplies
  • Hearing aids (for beneficiaries under 21)
  • Home and community-based services waiver services for targeted populations of developmentally disabled or mentally retarded individuals, older adults, physically disabled adults, medically fragile children, children with autism spectrum disorder, and adults with traumatic brain injury
  • Home health agency services
  • Hospice care
  • Hospital inpatient and outpatient services (acute, chronic, psychiatric, rehabilitation, specialty)
  • Kidney dialysis services
  • Laboratory and x-ray services
  • Medical day care services
  • Medical equipment and supplies
  • Medicare premiums, copayments and deductibles
  • Mental health treatment, case management, and rehabilitation services
  • Nurse anesthetist, nurse midwife, and nurse practitioner services nursing facility services (nursing homes)
  • Oxygen services and related respiratory equipment services
  • Personal care services
  • Pharmacy services (for beneficiaries not eligible for Medicare part D)
  • Physical therapy
  • Physician services (some dental surgery may be included)
  • Podiatry services
  • Private duty nursing (for beneficiaries under 21)
  • School-based health-related services (for beneficiaries under 21)
  • Statewide Evaluation and Planning Services (STEPS) through local health departments)
  • Substance use disorder treatment services
  • Targeted case management for HIV-infected individuals and other targeted populations
  • Transportation services to Medicaid covered services (through local health departments)
  • Vision care services (eye examination every two years)

What does my managed care organization (MCO) cover?

Your MCO through Medicaid covers doctor visits, pregnancy care, prescription drugs, hospital and emergency services, and more, at no cost.

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  • Visits to the doctor, including regular checkups and specialists
  • Pregnancy care
  • Family planning and birth control
  • Prescription drugs
  • Hospital and emergency services
  • Primary mental health services through your doctor

Compare MCOs (PDF)
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Maryland Children’s Health Program (MCHP)

Maryland Children’s Health Program (MCHP) covers full health benefits for children up to age 19. Benefits for children include these and more:

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  • Doctor visits including regular checkups and visits when sick
  • Hospitalizations, including lab work and tests
  • Immunizations like flu shots
  • Prescriptions
  • Dental care through the Maryland Healthy Smiles Dental Program
  • Vision care

Is dental care covered?

Your MCO may offer limited adult dental coverage.

  • Dental care is free for children and pregnant women enrolled in Medicaid and MCHP, as well as for adults in Rare and Expensive Case Management (REM).
  • You also can buy a standalone dental plan through Maryland Health Connection during the annual Open Enrollment period each fall.

Family Planning Program

The Family Planning Program covers family planning services for women and men whose income is too high to qualify for full-benefit Medicaid, but is below certain limits. If you do not qualify for full-benefit Medicaid, you may still be eligible for Medicaid coverage of family planning services, even if you are enrolled in a Qualified Health Plan. Learn more about the Family Planning Program.