What Medicaid is and what it covers

Medicaid is health coverage for people with low income. The federal government and each state pay for it together, and each state runs its own program within federal rules. That's why the name, the income limits and some of the benefits change from state to state. California calls it Medi-Cal, Tennessee calls it TennCare, and Wisconsin calls part of it BadgerCare.

Most people on Medicaid pay nothing or very little for their care. You don't pay a monthly premium in most states, and copays, where they exist, are small.

What every state has to cover

Federal law lists services every state program must pay for. They include:

• Hospital stays and outpatient hospital care
• Doctor and nurse practitioner visits
• Lab tests and X-rays
• Nursing home care for adults who need it, and home health care
• Family planning and pregnancy care
• Rides to medical appointments if you have no other way to get there

Children get more. Under a benefit called EPSDT, kids and teens under 21 get regular checkups and whatever treatment a doctor says they need, including dental, vision and hearing care.

What depends on your state

States can choose to cover more. Prescription drugs are covered in every state today, even though federal law lists them as optional. Adult dental care, eyeglasses, physical therapy and some mental health services vary. Your state Medicaid agency or your health plan can tell you exactly what you get.

Many states don't pay doctors directly. Instead, they sign you up with a private health plan (often called a managed care plan) that handles your Medicaid. You still have Medicaid; the plan's name is just on your card.

Sources: Medicaid & CHIP coverage, HealthCare.gov; Mandatory & optional Medicaid benefits, Medicaid.gov.