Medicaid Eligibility and Coverage Reference for Healthcare Providers
Quickly understand Medicaid eligibility criteria, covered services, and provider requirements for your state. Get answers from official statutory sources with the AI research assistant.
State Program Coverage at a Glance
Each state's Medicaid program is organized into content sections covering eligibility, covered services, managed care, transportation, dental, and more. All sourced from official state agencies.
Eligibility Determination
Research eligibility criteria by state. California provides presumptive eligibility for pregnant women. Texas enables immediate coverage under §32.026. Each state's approach is indexed with statutory citations.
Covered Services by State
New York alone covers 31 service categories including managed care, dental, doula services, CDPAP, transportation, cancer treatment (MCTP), and the EPIC pharmaceutical program.
Managed Care Programs
Track managed care requirements including network adequacy, enrollee rights, grievance systems, and quality measures. Indexed under both federal (42 CFR Part 438) and state provisions.
Provider Enrollment
Access provider enrollment requirements, credentialing standards, and participation rules. The platform indexes provider manuals and administrative codes from official state sources.
Ask Questions, Get Cited Answers
The AI research assistant answers questions about Medicaid coverage in plain language, grounded in the actual statutory text. Every answer includes citations so you can verify independently.
California Medi-Cal — Pregnant Women
Under the §1931(b) program, a pregnant woman with no other eligible children may not be aided until her last trimester (the last four months of pregnancy).
CPSP Services: All pregnant members must have access to Comprehensive Perinatal Services Program (CPSP) services, integrating health education, nutrition, and psychosocial services with obstetrical care.
- Coverage from conception through 60 days following delivery
- Continuous eligibility for mother and infant up to age one
- No prior authorization required for basic prenatal care
- Provider networks must include CPSP-certified providers
New York Medicaid: A Representative Example
See the depth of coverage available for each state. New York's program alone includes 31 content sections, 299 SPAs, and 11 official sources — all indexed and searchable.
| Program Area | Content Section | Last Updated |
|---|---|---|
| Managed Care | Medicaid Managed Care | 2026-02-24 |
| Pharmacy | Medicaid Pharmacy Program (NYRx) | 2026-02-24 |
| Dental | Dental Benefits | 2026-02-24 |
| Transportation | Medicaid Transportation | 2026-02-24 |
| Home Care | Consumer Directed Personal Assistance (CDPAP) | 2026-02-24 |
| Perinatal | Doula Services Benefit | 2026-02-24 |
| Cancer | Medicaid Cancer Treatment Program (MCTP) | 2026-02-24 |
Understand Your Patients' Coverage
Access the full platform to research Medicaid eligibility and services across all 52 jurisdictions.
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