Medicaid is a federally funded program which is administered by the state government. Every state has its own rules and guidelines on how they manage Medicaid benefits and to whom they will award these. Almost all states give Medicaid assistance to people who belong to low-income brackets. Each state has its own coverage restrictions for medical condition types. They also vary in what amount they will give dependent on the situation an individual might be. Medicaid prescriptions rules and guidelines are also different in every state.
A person who is a Medicaid benefits recipient may get Medicaid prescriptions coverage depending on where he is residing. Majority of states have Medicaid coverage for prescriptions, although there are some that do not cover particular types of prescriptions since they are allowed by the government to run their own Medicaid program as they please, as long as they comply with guidelines set by the federal government.
Medicaid prescriptions coverage is given to anyone who is qualified or currently receiving Medicaid benefits and assistance. If they are under the Medicare program, they may not qualify for Medicaid prescriptions benefits since this is already covered by Medicare. Medicaid may cover the prescription in some states that do cover medicines that are not included in coverage by Medicare Part D.
Almost all states have a monthly size limit for Medicaid prescriptions refills. Frequently the limit is set to be the same as a 30-day supply of the prescription. There are some states that permit a prescription refill that is good for 34 days. These states are Georgia, Idaho, Minnesota, Montana and Nevada. Examples of states which closely comply with the 30 day limit are Massachusetts and Rhode Island. A prescription refill for maintenance medicines that is good for 90 days is allowed in a good number of states like Colorado, Kentucky and New Hampshire. Other states do not permit large amounts of refills.
A lot of states regulate how many months a Medicaid prescription can be used or refilled. Alabama, Georgia, Kansas and Mississippi have set the limit to five refills to one prescription. Some have special thresholds for oral contraceptives. Medicines used for the treatment of recurring conditions like high blood pressure or asthma are usually exempted from limitations.
There are other states that demand a co-payment on Medicaid prescriptions. The Medicaid program exempts some groups of people from making co-payments for prescriptions. Pregnant women, minors and a number of people in certain institutions are not obliged to make a co-payment and they should not be declined Medicaid prescription coverage if they cannot pay the co-payment amount.
A good number of states have a catalog of medicines under their Medicaid prescriptions program. Although many different medicines may be part of the catalog, there are still others that are not part of the list. If an individual requires a specific type of medicine and it is not part of the covered medications, they can make a petition if the medication is very crucial. These petitions can be done at their local state Medicaid office.
A new law was put in effect last October 1, 2008 which require Medicaid prescriptions to be accomplished in tamper-proof prescription forms.