Does Medicaid cover prescription medications in every state?
While the basic answer is yes, coverage varies from state to state. The Federal government gave each state the option as to whether they provided prescription coverage or not. With the acceptance to offer prescription coverage by all 50 states and the District of Columbia, they were allowed to determine the coverage within federally mandated guidelines.
Who gets Medicaid prescription coverage?
Anyone eligible for Medicaid coverage may also receive the benefit of coverage for their prescription needs unless they are also receiving Medicare. If Medicare is also being received then that coverage takes care of prescription needs. There may be exceptions to this ruling, such as when an individual state decides to cover a medication that is not covered by Medicare Part D.
What are some of the restrictions individual states apply to prescription medications?
Some states may determine the number of prescriptions an individual may obtain, which can be determined on either a monthly or annual formula, while others may require a co-payment on prescriptions. Co-payment can be waived for certain sub-groups in the Medicaid system. Federal law requires that minors, pregnant women and some institutionalized persons not be required to pay a co-payment and that no one be refused prescription coverage due to inability to pay.
Many states also have listings of drugs they will cover under their Medicaid plan but if drugs are limited there must also be available a means to appeal the ban of a medication if it is medically necessary.
The basic answer again to the question does Medicaid cover prescription medications is yes, but you should check with your state to determine at what level.