Medicaid

Who Qualifies for Medicaid?

Many people can qualify for Medicaid, but the rules vary by state. Factors can include your income (and household size), age, disability status, pregnancy, state residency, and citizenship/immigration status.

Some states offer coverage to people in certain situations—for example, if you live in a nursing home or are caring for a child with a disability at home.

What Does Medicaid Cover?

Each state must provide basic medical services to people living below the poverty level. But for speech-language and hearing services, the rules change based on age.

Adults (age 21 and over)

States are not required to cover speech-language pathology or audiology services for adults, but some do.

To learn what your state covers:

• Visit the Centers for Medicare & Medicaid Services (CMS) website.
• Contact your state Medicaid agency for specific details.

Children (under age 21)

Medicaid offers a program for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT).

Under EPSDT, states must provide children under age 21 with:

• Hearing screenings
• Evaluations of speech, language, and communication skills

If a screening shows that a child needs help, the state must provide treatment. This can include services and devices like:

• Hearing aids
• Augmentative and alternative communication (AAC) devices
• Speech and hearing services

Speech and Hearing Services in Schools

Even though Medicaid is a medical assistance program, it funds some services delivered in schools. The federal government encourages states to use Medicaid to help pay for health-related services provided by schools—like speech therapy or hearing services—if certain rules are followed.

Contact your local school district and ask if they participate in the Medicaid program.

Medicaid coverage may vary between states, but support is available—especially for children. Don’t hesitate to ask questions and explore all your options.