What will Medicaid not pay for?

Answer 1

All sorts of things, which vary somewhat among the States - e.g., experimental care, care that's not medically necessarily to treat a condition or disease, etc.

You really need to ask the question as what will "you state" Medicaid not pay for? Like what will Ohio Medicaid not pay for? It can vary by state and changes all the time. Ohio uses medicaid managed care providers you get to choose from but switched so that they still use those but use direct medicaid for prescriptions. They also stopped paying for certain medications and limited amounts of certain medications. certain dental is no longer covered compared to years ago etc... You need to ask for your State. You can look up your Job and family Services website for your state to get some information and numbers to call as well.

If you are enrolled in Medicaid and have a managed care provider like Molina Healthcare, Caresource, etc. then if they haven't already ask them to mail you a handbook.

Answer 2

Medicaid is administered by the States, which have some discretion over coverage. However, for example, Medicaid will not pay for treatment that is experimental or cosmetic, that is provided by telephone, or where there is a less expensive alternative. Also, Medicaid will not pay for missed appointments.