With Medicaid, What Doctors and Other Providers Can I Use?
For Medicaid to cover any specific medical service, you must receive the care from a doctor or other healthcare provider who participates in Medicaid. Because Medicaid doesn't reimburse doctors and other providers at the same rate as private insurance does, many providers don't treat Medicaid patients. To make sure that Medicaid will cover any particular medical service, check with your healthcare providers in advance about whether they accept Medicaid patients.
Instead of looking for individual providers who accept Medicaid patients, many people enrolled in Medicaid receive their care through a Medicaid managed care plan, such as an HMO. These Medicaid managed care plans work in the same way that a Medicare Part C managed care plan does, with restrictions on the doctors and other providers you may use. If you enroll in a Medicaid managed care plan, there's no monthly premium, and no co-payments except to cover optional services beyond what Medicaid is required to provide (see FAQ: What Medical Services Does Medicaid Cover?).
In some states, you can choose from several of these Medicaid managed care plans. When you enroll in Medicaid, your local Medicaid office will give you information about what Medicaid managed care plans are available to you and how they work.
