Adult and Family Medicaid Covered Services

1.		Hospital inpatient Pre-Admission Review is required before you can be hospitalized for non-emergency care under Medicaid. Your medical condition is reviewed by medical professionals to determine if hospitalization is medically necessary. Certain surgical procedures must be done on an out-patient basis unless your medical condition requires you be hospitalized. Ask you doctor about Pre-Admission Review if you are to be hospitalized.
2.		Inpatient laboratory and x-ray service
3.		Hospice care
4.		Care through home health agencies
5.		Services of a nurse midwife
6.		Treatment in: a) Psychiatric hospitals (under age 21 and over age 64) b) Mental health center
7.		Six (6) prescription drugs per month including insulin
8.		Medical examinations and treatment for children and teenagers (under age 21)
9.		Annual physical examinations for adults
10.		Medically necessary ambulance transportation to nearest appropriate facility
11.		A total of 24 visits per year will be covered from a combination of the following services. Some restrictions exist. Prior approval is required for some services. Your doctor will know which ones. a) Physicians b) Hospital outpatient c) Outpatient laboratory and x-ray d) Podiatrists (foot doctors) e) Chiropractors f) Osteopaths (bone doctors) g) Eye examinations h) Clinic services including health department clinics i) Family planning services j) Hearing aid services
12.		If you become ill while in another state, Medicaid will pay for your emergency care if the medical providers bill the state.
The following services are covered with prior approval:
13.		Non-emergency care provided out-of-state more than forty miles from North Carolina when the service needed is not available in North Carolina.
14.		Care in a skilled nursing or intermediate care facility
15.		Durable medical equipment, such as hospital bed, wheel chair, etc.
16.		Limited dental services and medically necessary orthodontia for children
17.		Eyeglasses
18.		Hearing aids (under age 21 only)
19.		Personal care services in the home.

Note: People with certain life threatening illnesses are exempt from the physician and prescription limitations. Health Children and Teens program (8. above), annual physical exams for adults (9. above), prenatal care, and emergency room visits are also exempt.