Medicaid

Medicaid is a state health insurance program that helps individuals and families with low incomes pay for some or all of their medical bills. Coverage and reimbursement will vary from state to state, as well as year to year, depending on state legislative budget changes.

Patients with Medicaid will likely have coverage for all of their immunosuppressive medications; however, some states have prescription limits in place to control costs.

Patients who have Medicare and Medicaid are considered to be dually eligible for medication coverage. There are six different levels of Medicaid for dually eligible participants. Each level is based on financial need. Your Medicaid caseworker can help you find out which Medicaid plan you have and help you understand the specifics of your coverage. Talk with your social worker or financial coordinator for more information.

Download health claim forms for Medicare and Medicaid. To obtain all other claim forms, speak with your Transplant Financial Coordinator or contact your insurance company.

This is a general summary of Medicaid coverage, and is not a substitute for individual advice. This information may change, and you should always verify what information is applicable to you and your particular situation.

For additional information about Medicaid, visit the Medicaid website at www.cms.hhs.gov/medicaid.

Dually eligible patients (those with Medicare and Medicaid) are automatically enrolled in the Medicare Part D benefit. Post-transplant medications will be covered under Medicare Part D only if the medications are on the Part D plan, so be sure to check if your medications are on the plan.

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