Medicaid State Laws: Coverage & Navigation

Medicaid State Laws:
Coverage & Navigation

This chart highlights the state laws related to Medicaid coverage and navigation, expanded state Medicaid programs, clinical trials, premium payment programs, home help, retroactive coverage, and more. Check back often, as this chart is updated frequently.

If you don't find what you're looking for, see our other Charts of Medicaid State Laws:

For more information, visit our Medicaid Topics Page. If you are looking for state laws about health insurance generally, return to the main state laws page.

All Charts of State Laws

Medicaid Navigation

State	Name of Medicaid Program	Link to Medicaid Program	Has Expanded State Medicaid Program	Medicaid Links	Has a Health Insurance Premium Payment Program	HIPP Law	Home Help Programs	Home Help Program Links	Has a program for workers with disabilities	Name of program for workers with disabilities	Hyperlink to the workers with disabilities program
ALABAMA	Medicaid	https://medicaid.alabama.gov/			x	https://www.myalhipp.com/index.html	x	https://medicaid.alabama.gov/content/6.0_LTC_Waivers/6.3_Other_LTC_Programs/6.3.1_Home_Health.aspx	N
ALASKA	Medicaid	https://health.alaska.gov/dpa/Pages/medicaid/default.aspx	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=alaska	x	https://www.myakhipp.com/	x	http://dhss.alaska.gov/dsds/Pages/pca/default.aspx	Y	Working Disabled Medicaid Buy-In	http://dpaweb.hss.state.ak.us/manuals/adltc/adltc.htm#t=534_working_disabled_medicaid_buy-in%2F534_working_disabled_medicaid_buy-in.htm
ARIZONA	Arizona Health Care Cost Containment System (AHCCCS)	https://www.azahcccs.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=arizona			Includes payments to family caregivers	https://www.azahcccs.gov/PlansProviders/CurrentProviders/SDAC.html	Y	Arizona Health Care Cost Containment System (AHCCCS) Freedom to Work Program	https://www.azahcccs.gov/Members/GetCovered/Categories/workingdisabled.html
ARKANSAS	Arkansas Medicaid	https://access.arkansas.gov/Learn/Home	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=arkansas	x	https://www.myarhipp.com/	Includes payments to family caregivers	https://humanservices.arkansas.gov/divisions-shared-services/aging-adult-behavioral-health-services/find-home-community-based-services-for-adults-seniors/archoices-in-homecare/	Y	Workers with Disabilities	https://humanservices.arkansas.gov/divisions-shared-services/county-operations/health-care-programs/
CALIFORNIA	Medi-Cal	https://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=california	x	http://dhcs.ca.gov/hipp	Includes payments to family caregivers	https://www.cdss.ca.gov/In-Home-Supportive-Services	Y	250% Working Disabled Program (250% WDP)	https://www.dhcs.ca.gov/services/Pages/TPLRD_WD_cont.aspx#:~:text=The%20250%25%20Working%20Disabled%20Program,the%20local%20county%20welfare%20department.
COLORADO	Health First Colorado	https://www.healthfirstcolorado.com/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=colorado	x	https://www.mycohibi.com/what-is-colorado-hibi/index.html	Includes payments to family caregivers	https://hcpf.colorado.gov/in-home-support-services	Y	Health First Colorado Buy-In Program for Working Adults with Disabilities	https://hcpf.colorado.gov/buy-in-program-working-adults-disabilities
CONNECTICUT	Husky Health	https://portal.ct.gov/HUSKY	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=connecticut			Includes payments to family caregivers	https://ctcommunitycare.org/community-first-choice	Y	Medicaid for Employees with Disabilities (MED-Connect)	https://portal.ct.gov/DSS/Health-And-Home-Care/Disability-Services/Med-Connect-Medicaid-for-Employees-with-Disabilities/Med-Connect-Medicaid-for-Employees-with-Disabilities#:~:text=Overview&text=Medicaid%20for%20Employees%20with%20Disabilities%2C%20also%20known%20as%20MED%2DConnect,full%20Medicaid%2FHUSKY%20Health%20coverage.
DELAWARE	Medicaid	https://dhss.delaware.gov/dmma/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=delaware			Includes payments to family caregivers	https://www.dhss.delaware.gov/dss/homeandc.html	Y	Medicaid for Workers with Disabilities (MWD) Program	https://dhss.delaware.gov/dhss/dmma/files/an_202306.pdf
*DISTRICT OF COLUMBIA	DC Medicaid	https://dhcf.dc.gov/service/medicaid	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=district-of-columbia			x	https://dhcf.dc.gov/page/epd-waiver-services	N
FLORIDA	Florida Medicaid	https://www.flmedicaidmanagedcare.com/			x	https://www.flrules.org/gateway/ruleno.asp?id=59G-7.007	Includes payments to family caregivers	https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/find-out-about-long-term-care-services	Y	Working People with Disabilities	https://ahca.myflorida.com/medicaid/medicaid-policy-quality-and-operations/medicaid-policy-and-quality/medicaid-policy/federal-authorities/working-people-with-disabilities
GEORGIA	Georgia Medical Assistance	https://medicaid.georgia.gov/	Georgia has not expanded Medicaid, however, it has a Pathways to Coverage program	https://dch.georgia.gov/georgiapathways/eligibility-criteria	x	https://medicaid.georgia.gov/third-party-liability/health-insurance-premium-payment-program-hipp	Includes payments to family caregivers	https://dch.georgia.gov/sites/dch.georgia.gov/files/related_files/document/17CCSP.pdf	Y	Georgia Medicaid for Workers with Disabilities (GMWD)	https://medicaid.georgia.gov/document/publication/medicaid-georgia-workers-disabilities/download
HAWAII	Med Quest	https://medquest.hawaii.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=hawaii	x	https://mybenefits.hawaii.gov/hawaii-health-care-premium-assistance-program/	x	https://medquest.hawaii.gov/en/members-applicants/already-covered/my-choice-my-way.html	Y	Working Individuals with Disabilities - TWWIIA	https://medquest.hawaii.gov/content/dam/formsanddocuments/med-quest/hawaii-state-plan/spa-memos/SPA_21-04_Distribution_Memo.pdf
IDAHO	Medicaid	https://healthandwelfare.idaho.gov/services-programs/medicaid-health	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=idaho			x	https://healthandwelfare.idaho.gov/services-programs/medicaid-health/home-and-community-based-services	Y	Medicaid for Workers with Disabilities (MWD)	https://healthandwelfare.idaho.gov/services-programs/medicaid-health/medicaid-workers-disabilities
ILLINOIS	Illinois Medicaid	https://hfs.illinois.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=illinois	x	https://www.dhs.state.il.us/page.aspx?Item=19229	x	https://www.dhs.state.il.us/page.aspx?item=18142	Y	Health Benefits for Workers with Disabilities (HBWD)	https://hfs.illinois.gov/medicalprograms/hbwd.html
INDIANA	Indiana Medicaid	https://www.in.gov/medicaid/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=indiana			x	https://www.in.gov/fssa/da/3476.htm	Y	M.E.D. Works (through the Hoosier Care Connect program)	https://www.in.gov/fssa/ompp/med-works/
IOWA	Iowa Medicaid	https://hhs.iowa.gov/programs/welcome-iowa-medicaid	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=iowa	x	https://hhs.iowa.gov/programs/welcome-iowa-medicaid/fee-service/hipp	x	https://hhs.iowa.gov/programs/welcome-iowa-medicaid/iowa-medicaid-programs/home-health	Y	Medicaid for Employed People with Disabilities (MEPD)	https://hhs.iowa.gov/programs/welcome-iowa-medicaid/iowa-medicaid-programs/mepd
KANSAS	KanCare program	https://kancare.ks.gov/			x	http://content.dcf.ks.gov/ees/KEESM/Miscform/MS-2504HEALTH_INSURANCE_PREMIUM_PAYMENT_INFORMATION_FORM1-05.pdf	x	https://www.kdads.ks.gov/commissions/commission-on-aging/aging-and-disability-resource-centers/service-information/in-home-services	Y	Working Healthy Medicaid Buy-In Program	https://www.kancare.ks.gov/consumers/working-healthy
KENTUCKY	Kentucky Medicaid	https://kynect.ky.gov/benefits/s/medicaid-kchip-program?language=en_US	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=kentucky	x	https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx	Includes payments to family caregivers	https://chfs.ky.gov/agencies/dms/dca/Pages/hcb-waiver.aspx	Y	Medicaid Works	https://www.chfs.ky.gov/agencies/dms/dpo/epb/Pages/medicaid-works.aspx
LOUISIANA	Medicaid	https://ldh.la.gov/subhome/1	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=louisiana	x	http://www.ldh.la.gov/index.cfm/page/2693	Includes payments to family caregivers	https://ldh.la.gov/page/longterm-care	Y	Medicaid Purchase Plan	https://ldh.la.gov/page/medicaid-purchase-plan
MAINE	MaineCare	https://www.maine.gov/dhhs/oms	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=maine	x	https://www.maine.gov/dhhs/oms/mainecare-options/limited-benefits	x	https://www.maine.gov/dhhs/oads/get-support/older-adults-disabilities/home-care	Y	MaineCare for Working People with Disabilities	https://www.maine.gov/dhhs/sites/maine.gov.dhhs/files/inline-files/2023%20WD%20Brochure_1.pdf
MARYLAND	Maryland Medicaid	https://health.maryland.gov/mmcp/Pages/home.aspx	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=maryland			Includes payments to family caregivers	https://health.maryland.gov/mmcp/longtermcare/Pages/Community-First-Choice.aspx	Y	Employed Individuals with Disabilities (EID) Program	https://health.maryland.gov/mmcp/eid/pages/home.aspx
MASSACHUSETTS	MassHealth	https://www.mass.gov/topics/masshealth	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=massachusetts	x	https://www.mass.gov/info-details/masshealth-premium-assistance-pa	Includes payments to family caregivers	https://www.mass.gov/in-home-services	N
MICHIGAN	Michigan Medicaid	https://www.michigan.gov/mdhhs/assistance-programs/medicaid	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=michigan			Includes payments to family caregivers	https://www.michigan.gov/mdhhs/0,5885,7-339-71547_2943_4857_5045-16263--,00.html	Y	Freedom to Work (FTW)	https://www.michigan.gov/mdhhs/assistance-programs/medicaid/portalhome/beneficiaries/programs/freedom-to-work
MINNESOTA	Minnesota Medical Assistance	https://mn.gov/dhs/people-we-serve/adults/health-care/health-care-programs/programs-and-services/medical-assistance.jsp	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=minnesota	x	https://mn.gov/dhs/people-we-serve/children-and-families/health-care/health-care-programs/programs-and-services/other-insurance.jsp	x	https://mn.gov/dhs/people-we-serve/people-with-disabilities/services/home-community/programs-and-services/pca.jsp	Y	Medical Assistance for Employed Persons with Disabilities (MA-EPD)	https://mn.gov/dhs/people-we-serve/people-with-disabilities/health-care/health-care-programs/programs-and-services/ma-epd.jsp
MISSISSIPPI	Mississippi Medicaid	https://medicaid.ms.gov/					x	http://medicaid.ms.gov/programs/independent-living-waiver/	Y	Working Disabled	https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/working-disabled/
MISSOURI	MO HealthNet	https://mydss.mo.gov/healthcare/apply	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=missouri	x	https://dss.mo.gov/mhd/participants/pages/hipp.htm	x	https://health.mo.gov/seniors/nursinghomes/careoptions.php	Y	Ticket-to-Work Health Assurance (TWHA)	https://dmh.mo.gov/medicaid-eligibility/twha
MONTANA	Montana Medicaid	https://dphhs.mt.gov/montanahealthcareprograms/memberservices	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=montana	x	https://dphhs.mt.gov/montanahealthcareprograms/HIPP	x	https://dphhs.mt.gov/sltc/csb	Y	Medicaid for Workers with Disabilities (MWD)	https://www.dphhs.mt.gov/assets/hcsd/mamanual/ABD010.pdf
NEBRASKA	Medicaid	https://dhhs.ne.gov/Pages/Medicaid-Clients.aspx	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=nebraska	x	http://dhhs.ne.gov/Pages/Health-Insurance-Premium-Payment.aspx	Includes payments to family caregivers	https://dhhs.ne.gov/Pages/Medicaid-Home-and-Community-Based-Programs.aspx	Y	Medicaid Insurance for Workers with Disabilities (MIWD)	https://dhhs.ne.gov/Pages/MIWD.aspx
NEVADA	Medicaid	https://www.medicaid.nv.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=nevada	x	https://dhcfp.nv.gov/Pgms/CPT/HIPP/	x	https://dhcfp.nv.gov/Pgms/LTSS/LTSSPCS/	Y	Health Insurance for Work Advancement (HIWA)	https://dwss.nv.gov/uploadedFiles/dwssnvgov/content/Medical/B-300%20-%20Medical%20Assistance%20for%20the%20Aged,%20Blind,%20and%20Disabled%20(MAABD)%20Medical%20Categories.pdf
NEW HAMPSHIRE	New Hampshire Medicaid	https://www.dhhs.nh.gov/programs-services/medicaid	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=new-hampshire	x	https://www.dhhs.nh.gov/programs-services/medicaid/health-insurance-premium-program	x	https://www.dhhs.nh.gov/programs-services/adult-aging-care/nhcarepath/nhcarepath-home-care-information	Y	Medicaid for Employed Adults with Disabilities (MEAD)	https://www.dhhs.nh.gov/programs-services/medicaid/nh-medicaid-medical-assistance-eligibility/mead-and-moad-eligibility
NEW JERSEY	New Jersey FamilyCare	https://njfamilycare.dhs.state.nj.us/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=new-jersey			Includes payments to family caregivers	https://www.state.nj.us/humanservices/dmahs/clients/njppp.html	Y	NJ WorkAbility	https://www.nj.gov/humanservices/dds/programs/njworkability/
NEW MEXICO	Centennial Care	https://www.hsd.state.nm.us/lookingforassistance/centennial-care-overview/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=new-mexico			x	https://www.hsd.state.nm.us/community-benefit-program/	Y	Working Disabled Individuals (WDI)	https://www.hsd.state.nm.us/wp-content/uploads/8.243.400-NMAC-Final.pdf
NEW YORK	New York Medicaid	https://www.health.ny.gov/health_care/medicaid/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=new-york			Includes payments to family caregivers	https://www.health.ny.gov/health_care/medicaid/program/longterm/cdpap.htm	Y	Medicaid Buy-In Program for Working People with Disabilities (MBI-WBD)	https://www.health.ny.gov/health_care/medicaid/program/buy_in/
NORTH CAROLINA	North Carolina Medicaid	https://medicaid.ncdhhs.gov/	x	https://medicaid.ncdhhs.gov/north-carolina-expands-medicaid	x	https://medicaid.ncdhhs.gov/beneficiaries/get-started/find-programs-and-services/health-insurance-premium-payment-program	x	https://medicaid.ncdhhs.gov/medicaid/get-started/find-programs-and-services/community-alternatives-program-for-disabled-adults	Y	Health Coverage for Workers with Disabilities (HCWD)	https://medicaid.ncdhhs.gov/beneficiaries/apply/eligibility/medicaid-workers-disabilities
NORTH DAKOTA	Medicaid	https://www.hhs.nd.gov/healthcare/medicaid	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=north-dakota			Includes payments to family caregivers	https://www.hhs.nd.gov/adults-and-aging/homecare	Y	Workers with Disabilities Coverage	https://www.hhs.nd.gov/healthcare-coverage/medicaid/coverage-workers
OHIO	Ohio Medicaid	https://medicaid.ohio.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=ohio			x	https://medicaid.ohio.gov/wps/portal/gov/medicaid/families-and-individuals/citizen-programs-and-initiatives/hcbs	Y	Medicaid Buy-In for Workers with Disabilities (MBIWD)	https://medicaid.ohio.gov/families-and-individuals/citizen-programs-and-initiatives/medicaid-buy-in-for-workers-with-disabilities
OKLAHOMA	SoonerCare	https://oklahoma.gov/ohca.html	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=oklahoma			x	https://oklahoma.gov/ohca/individuals/home-and-community-based-services-hcbs-waivers.html	N
OREGON	Oregon Health Plan	https://www.oregon.gov/oha/hsd/ohp/pages/index.aspx	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=oregon	x	https://www.oregon.gov/odhs/financial-recovery/Pages/hipp.aspx	Includes payments to family caregivers	https://www.oregon.gov/odhs/home-care-consumers/Pages/default.aspx	Y	Employed Persons with Disabilities (EPD)	https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/de9029.pdf
PENNSYLVANIA	Pennsylvania Medical Assistance	https://www.dhs.pa.gov/Services/Assistance/Pages/Medical-Assistance.aspx	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=pennsylvania	x	https://www.dhs.pa.gov/Services/Assistance/Pages/HIPP-Program.aspx	Includes payments to family caregivers	https://www.dhs.pa.gov/Services/Assistance/Pages/Home-and-Community-Based%20Services.aspx	Y	Medical Assistance for Workers with Disabilities (MAWD)	https://www.dhs.pa.gov/Services/Assistance/Pages/MA-for-Disabled-Workers.aspx
*PUERTO RICO	Medicaid	https://medicaid.salud.pr.gov/?AspxAutoDetectCookieSupport=1							N
RHODE ISLAND	Rhode Island Medical Assistance	https://dhs.ri.gov/programs-and-services/medicaid-medicare-programs	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=rhode-island	x	https://eohhs.ri.gov/Consumer/FamilieswithChildren/RIteShare.aspx	x	https://eohhs.ri.gov/Consumer/ConsumerInformation/Healthcare/LongTermServicesandSupports/HomeandCommunityBasedServices.aspx	Y	The Sherlock Plan - Medicaid for Working People with Disabilities Program	https://eohhs.ri.gov/Consumer/TheSherlockPlan.aspx
SOUTH CAROLINA	Healthy Connections	https://www.scdhhs.gov/			x	https://www.scdhhs.gov/health-insurance-premium-payment-hipp	Includes payments to family caregivers	https://www.scdhhs.gov/resources/programs-and-initiatives/home-and-community-based-services	Y	Working Disabled	https://www.scdhhs.gov/members/program-eligibility-and-income-limits
SOUTH DAKOTA	Medicaid	https://dss.sd.gov/medicaid/	x	https://dss.sd.gov/medicaid/	x	https://dss.sd.gov/formsandpubs/docs/MEDSRVCS/MS07_Premium_Assistance.pdf	x	https://dhs.sd.gov/en/ltss/hope-waiver	Y	Medicaid for Workers with Disabilities (MAWD)	https://dss.sd.gov/economicassistance/medical_programs.aspx
TENNESSEE	TennCare	https://www.tn.gov/tenncare/members-applicants/eligibility/tenncare-medicaid.html					x	https://www.tn.gov/tenncare/long-term-services-supports/choices.html	N
TEXAS	Medicaid	https://www.hhs.texas.gov/services/health/medicaid-chip			x	https://hhs.texas.gov/services/financial/health-insurance-premium-payment-hipp-program	x	https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/community-first-choice-cfc	Y	Medicaid Buy-In for Adults (MBI)	https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-programs-services/programs-children-adults-disabilities/medicaid-buy-adults
UTAH	Medicaid	https://medicaid.utah.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=utah	x	https://medicaid.utah.gov/upp/faq/	x	https://medicaid.utah.gov/ltc-2/	Y	Medicaid Work Incentive (MWI)	https://medicaid.utah.gov/medicaid-work-incentive-program/
VERMONT	Vermont Medicaid	https://dvha.vermont.gov/members	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=vermont	x	https://dvha.vermont.gov/members/medicaid/hipp-program	x	https://dvha.vermont.gov/members/long-term-care	Y	Medicaid for Working People with Disabilities (MWPD)	https://dvha.vermont.gov/members/medicaid/medicaid-aged-blind-or-disabled-mabd
VIRGINIA	Medicaid	https://www.dmas.virginia.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=virginia	x	https://coverva.dmas.virginia.gov/learn/premium-assistance/health-insurance-premium-payment-hipp-programs/	Includes payments to family caregivers	https://www.vda.virginia.gov/homecbs.htm	Y	Medicaid Works	https://www.dmas.virginia.gov/for-members/for-adults/aged-blind-or-disabled/medicaid-works-medicaid-buy-in/
WASHINGTON	Apple Health	https://www.hca.wa.gov/free-or-low-cost-health-care/apple-health-you	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=washington	x	https://www.hca.wa.gov/health-care-services-supports/program-administration/premium-payment-program	x	https://www.hca.wa.gov/free-or-low-cost-health-care/i-need-medical-dental-or-vision-care/health-home	Y	Apple Health for Workers with Disabilities (HWD)	https://www.dshs.wa.gov/esa/community-services-offices/apple-health-workers-disabilities-hwd-program
WEST VIRGINIA	West Virginia Medicaid	https://www.wvpath.wv.gov/	x	https://www.medicaid.gov/state-overviews/stateprofile.html?state=west-virginia	x	https://www.mywvhipp.com/	x	http://www.wvseniorservices.gov/HelpatHome/MedicaidAgedandDisabledWaiver/tabid/77/Default.aspx	Y	Medicaid Work Incentive (M-WIN)	https://dhhr.wv.gov/bms/BMSPUB/Documents/Guide%20to%20Medicaid%202023.pdf
WISCONSIN	BadgerCare Plus	https://www.dhs.wisconsin.gov/badgercareplus/index.htm			x	https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm	Includes payments to family caregivers	https://www.dhs.wisconsin.gov/familycare/whatisfc.htm	Y	Medicaid Purchase Plan (MAPP)	https://www.dhs.wisconsin.gov/medicaid/medicaid-purchase-plan.htm
WYOMING	Medicaid	https://health.wyo.gov/healthcarefin/medicaid/			x	https://health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/	x	https://health.wyo.gov/healthcarefin/hcbs/	Y	Employed Individuals with Disabilities (EID)	https://health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/
GUAM	Medicaid	https://www.medicaid.gov/state-overviews/guam.html	x	https://www.medicaid.gov/state-overviews/guam.html					N
LAST UPDATE	3/2024		12/2023		12/2023		12/2023

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Medicaid Coverage

State	Medicaid Coverage of Clinical Trials Routine Costs	Hyperlink to State Law/Policy	Details of Medicaid Coverage for Clinical Trials Routine Costs
ALABAMA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
ALASKA	x (also covered under federal law)	http://www.akleg.gov/basis/Bill/Text/26?Hsid=SB0010Z	Health care insurers in the state must cover routine costs associated with clinical trials “designed to test and improve prevention, diagnosis, treatment or palliation of cancer.” Directs insurers to provide Medicaid services for individuals participating in these trials.
ARIZONA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
ARKANSAS	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
CALIFORNIA	x (also covered under federal law)	http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=200120020SB37	If a patient’s physician recommends a clinical trial, every health care insurer in the state (including Medi-Cal) must cover routine costs associated with that trial. Effective August 10, 2001 (SB 37)
COLORADO	x (also covered under federal law)	https://leg.colorado.gov/bills/hb20-1232	If a patient's physician determines that the patient has a life-threatening or debilitating disease or condition, Medicaid will cover the routine costs associated with an approved clinical trial. Effective July 10, 2020 (HB20-1232).
CONNECTICUT	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
DELAWARE	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
*DISTRICT OF COLUMBIA	x (also covered under federal law)	http://dccode.elaws.us/code?no=31-29B&e=8	Under state health insurance code 31-2993.02 (October 23, 2012), the District of Columbia Medicaid agency may not “not limit or deny coverage, or impose additional conditions on the payment for the coverage, of routine patient care costs” associated with clinical trials.
FLORIDA	x (also covered under federal law)	https://www.flrules.org/gateway/ruleno.asp?id=59G-1.036	Florida Administrative Code 59G-1.036 (January 6, 2006) requires that “Florida Medicaid reimburses for services as a result of a recipient participating in a clinical trial.”
GEORGIA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
HAWAII	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
IDAHO	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
ILLINOIS	x (also covered under federal law)	https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1864&GAID=15&DocTypeID=SB&LegID=119534&SessionID=108&GA=101&SpecSess=0	Under Public Act 101-0649, the state's Medicaid program covers "routine care costs that are incurred in the course of an approved clinical trial if the medical assistance program would provide coverage for the same routine care costs not incurred in a clinical trial." Effective July 7, 2020.
INDIANA	x (also covered under federal law)	https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-15-5-9-2.html	Medicaid program must provide coverage for routine care costs that are incurred in the course of a clinical trial if the Medicaid program would provide coverage for the same routine care costs not incurred in a clinical trial
IOWA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
KANSAS	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
KENTUCKY	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
LOUISIANA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
MAINE	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
MARYLAND	x (also covered under federal law)	https://mmcp.health.maryland.gov/healthchoice/Documents/MCO%20Agreement%202019%20for%20CY%202019%20MCO%20file.pdf	Section .26-1 of Maryland’s Medicaid managed care organization agreement mandates that Maryland managed care organizations cover routine costs associated with clinical trials.
MASSACHUSETTS	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
MICHIGAN	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
MINNESOTA	x (also covered under federal law)	https://www.revisor.mn.gov/statutes/cite/62Q.526	A health plan company cannot deny participation by a qualified individual in an approved clinical trial; deny, limit, or impose additional conditions on the coverage of routine patient costs for items or services furnished in connection with participation in the trial; or discriminate against an individual on the basis of an individual's participation in an approved clinical trial.
MISSISSIPPI	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
MISSOURI	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
MONTANA	x (also covered under federal law)	https://legiscan.com/MT/text/SB55/id/791917	Health insurance providers, including Medicaid, may not deny patients’ participation in an approved clinical trial, deny coverage of routine patient costs, or discriminate against an individual due to their participation in an approved clinical trial.
NEBRASKA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
NEVADA	x (also covered under federal law)	http://dhcfp.nv.gov/uploadedFiles/dhcfpnvgov/content/Resources/AdminSupport/Manuals/MSM/C1500/MSM_Ch_1500_20_01_01.pdf	The Healthy Kids Program policy #15-1 (November 1, 2014) requires Medicaid to cover routine costs for phase III and IV clinical trials for children less than 21 years old.
NEW HAMPSHIRE	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
NEW JERSEY	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
NEW MEXICO	Covered under federal law	https://www.nmlegis.gov/Sessions/09%20Regular/final/SB0042.pdf	As of 2009, New Mexico insurance code requires that all health care insurers in the state (including Medicaid) cover routine costs associated with clinical trials.
NEW YORK	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
NORTH CAROLINA	x (also covered under federal law)	https://files.nc.gov/ncdma/documents/files/1A39.pdf	As of October 1, 2015, North Carolina Medicaid programs cover qualifying clinical trials’ routine costs.
NORTH DAKOTA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
OHIO	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
OKLAHOMA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
OREGON	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
PENNSYLVANIA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
*PUERTO RICO
RHODE ISLAND	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
SOUTH CAROLINA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
SOUTH DAKOTA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
TENNESSEE	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
TEXAS	x (also covered under federal law)	https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1379.htm	All health care insurers in the state, including Medicaid Plans, must cover routine costs associated with approved “clinical trials conducted in relation to the prevention, detection, or treatment of a life-threatening disease or condition.” (Insurance Code Section 1379.001)
UTAH	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
VERMONT	x (also covered under federal law)	https://dfr.vermont.gov/reg-bul-ord/health-insurance-coverage-cancer-clinical-trial	Vermont’s Health Care Administration requires Vermont Medicaid providers to cover routine costs associated with clinical trials as of August 5, 2005. (Regulation H-2005-03)
VIRGINIA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
WASHINGTON	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
WEST VIRGINIA	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
WISCONSIN	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
WYOMING	Covered under federal law	https://www.congress.gov/bill/116th-congress/house-bill/133/text
GUAM
LAST UPDATE	12/23

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