National Health Law Program works to ensure that enrollees can promptly and adequately access the services they need
Medicaid covers a broad range of services for low-income populations. Federal law requires every state Medicaid program to cover a set of “mandatory” benefits, such as hospitalization, doctor visits, and family planning services. States must also cover comprehensive screening and treatment services for children under the age of 21 without the coverage limits that might apply to adults.
Beyond mandatory services, most states also provide at least some critical “optional” services, such as dental care, physical therapy, and various home and community-based services for individuals with disabilities. All services – whether mandatory or optional – must be sufficient to achieve their purpose.
National Health Law Program works to ensure that enrollees can promptly and adequately access the services that they need.