Medicaid & CHIP After Health Reform - South Carolina Institute of ...

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Benefits for the Newly Eligible • Benchmark/benchmark equivalent benefits • Must include “essential health benefits” – Ambulatory care, emergency, hospital, maternity/newborn, behavioral health, Rx drugs, rehabilitative and habilitative services, lab services, preventive/wellness/disease management, pediatric services including oral and vision • Also must include family planning services and transportation services • Dental and vision not required for adults 10
Benefits (continued) • Existing <strong>Medicaid</strong> cost-sharing rules apply • New enrollees may have greater need for: – Mental health services – Chronic disease management • Given 2/3 were previously uninsured, may be pent up demand in early years <strong>of</strong> expansion 11
Page 1: Medicaid & CHIP After Health Reform
Page 4 and 5: Financing
Page 6 and 7: Medicaid Expansion in South Carolin
Page 8 and 9: Who Will Gain Coverage? • Estimat
Page 12 and 13: MAGI What does MAGI mean for health
Page 14 and 15: MAGI: Easier for Some Groups to Qua
Page 16 and 17: Access to Care for New Eligibles
Page 18 and 19: Improving Enrollment in Public Prog
Page 20 and 21: What Can My State Do Before 2014?

Medicaid & CHIP After Health Reform - South Carolina Institute of ...

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