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Medicaid benefits

Medicaid is health insurance for people who meet certain conditions for income, age or health. This may include children, pregnant women, older adults and people with disabilities.

What does Medicaid cover?

Some Medicaid benefits are offered in all states. The federal government gives states money for these benefits.

States must offer certain Medicaid benefits, such as:

  • Family planning services
  • Family nurse practitioner services
  • Freestanding birth center services 
  • Health center services
  • Home health services
  • Inpatient and outpatient hospital services
  • Laboratory and X-ray services
  • Nursing facility services
  • Pediatric care (including early and periodic screening, diagnostic and treatment services [EPSDT])
  • Physician services
  • Pregnancy-related services (including nurse-midwife services for pregnancy and postpartum care)
  • Rural health clinic services
  • Tobacco-cessation counseling for pregnant women
  • Transportation to medical care for eligible individuals 
Learn more about what Medicaid covers

How do Medicaid benefits vary by state?

States use federal regulations to create and run Medicaid programs. Medicaid eligibility is based on income, and the value of what you own.

Learn how Medicaid varies by state. States may choose to offer more benefits and services through Medicaid. These are called optional benefits. They may also choose to provide coverage to larger groups of people.

Learn how Medicaid can vary from state to state

What benefits does Medicaid cover in my state?

Medicaid benefits can change depending on where you live. Search by selecting your state to find the right UnitedHealthcare Community plan to meet your health care needs.

What benefits does Medicaid cover in my state?

Medicaid benefits can change depending on where you live. Search by selecting your state to find the right UnitedHealthcare Community plan to meet your health care needs.

Frequently asked questions about Medicaid benefits

Does Medicaid cover home health care?

Yes, the federal government requires all 50 states to offer some Medicaid home health care benefits. The types of home health care services offered depend on where you live.

Learn about Medicaid home health services

Does Medicaid cover dental care?

Medicaid offers dental benefits to all youth under age 21. Adult dental coverage is optional and varies by state.

Learn about Medicaid dental benefits

Does Medicaid provide coverage for pregnant women and babies?

Medicaid covers low-income pregnant women in all states. If a pregnant woman is covered by Medicaid, their baby is too. The baby is enrolled in Medicaid for the first year of their life.

Learn more about Medicaid pregnancy coverage

Does CHIP cover pregnant women and children?

The Children’s Health Insurance Program (CHIP) also covers pregnant women and babies in some states. CHIP may cover those who don't qualify for Medicaid. Each state offers CHIP coverage and works closely with its state Medicaid program.

Learn more about CHIP

Disclaimer information

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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only. Access to this service is subject to terms of use.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2026.

Formularies

The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.