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Free or Reduced Drugs With Medicaid

by Katarina Fitzpatrick
  • Overview

    Only some prescription drugs are covered by Medicaid, as it varies by state.
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    Medicaid is a joint federal-state funded program that provides free health care to eligible low-income individuals in the U.S. The Kaiser Family Foundation reports that states receive federal funds for many "optional" services, including prescription drugs. The types of free or reduced-price drugs available to Medicaid beneficiaries entirely depend on each state's rules.
  • Coverage

    The Library of Congress' Congressional Research Service published a newsletter in February 2006 stating that the amount of prescription drug coverage under Medicaid shall be allotted by each state. If states choose to cover certain prescription drugs, they must only be provided "medically needy individuals, persons who are not poor by cash welfare standards, but who require help with medical expenses." Presently, 33 states provide prescription drug coverage to all Medicaid beneficiaries.
 
  • Facts

    In January 2006, many elderly and disabled Medicaid beneficiaries began receiving prescription drug coverage under Medicare (a similar federally-funded program that provides health care services to those aged 65 and older). In 2006, Medicaid spent $304 billion for services in the U.S. Of these funds, 5.5 percent, or $16.7 million, were spent on prescription drugs.
  • Brand Name vs. Generic

    States may choose whether their Medicaid beneficiaries are allowed brand-name, generic prescriptions or both. Some state programs will only allow beneficiaries to receive generic drugs. These generally have a lower co-pay and contain the same active chemical compounds as brand-name drugs, therefore producing the same or similar effects, according to the Palo Alto Medical Foundation.
  • Exceptions

    While certain prescription drugs are not covered in all 50 states under Medicaid, CMS now allows patients with breast and cervical cancers, tuberculosis, and sickle cell disease special coverage conditions, including full assistance with prescription payments, among other services.
  • For more information

    Expanding Medicaid is currently one of the leading health reform proposals in Congress, as of October 2009. Under the new Medicare Part D drug benefit rules (with certain restrictions), state Medicaid programs will continue to contribute to the costs of prescription drugs under Medicare. To find out whether you qualify for Medicaid, contact your state's or local Medicaid office via phone or on the Internet.

    References & Resources