Medicaid Benefits
The federal government requires states to provide certain types of medical services to individuals who are entitled to full Medicaid benefits. States have the option to include other benefits as part of the core benefit package offered by the state. Physician services and hospital inpatient and outpatient services are all mandatory benefits. Prescription drugs are considered an optional benefit, although all state Medicaid programs offer this benefit.
Other types of Medicaid are designed specifically to assist individuals with Medicare premiums, co-insurances, and deductibles. The table below lists the benefits provided by some of the different types of Medicaid.
| Medicaid Pathway | Benefits Provided |
|
Traditional Medicaid
(full benefits) |
All mandatory Medicaid benefits and optional benefits as determined at the state
level
Medicare Part B premium for Medicare eligibles |
| Qualified Medicare Beneficiary (QMB) |
Medicare Part A premium
Medicare Part B premium Medicare Part A and B cost sharing (deductibles and coinsurances) |
|
Specified Low-Income Beneficiary (SLMB)
|
Medicare Part B premium |
|
Qualifying Individual (QI)
|
Medicare Part B premium |
|
Qualified Disabled and Working Individual (QDWI)
|
Medicare Part A premium |
