Amerigroup Medicaid

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Plan Information

Current as of 07/22/2020

Amerigroup is a health insurance partner that offers Medicaid and serves people who are eligible. Medicaid is a health insurance program for individuals with low income. Most people pay very little – and some pay nothing at all for Medicaid.

Medicaid insurance covers things like doctor visits, hospital stays, labs and X-rays. Other benefits, like prescriptions, vision, and dental care, may also be covered, depending on age and what area an individual resides.

What Medicaid covers for Medicare Enrollees

Medicare has four basic forms of coverage:

  • Part A- Pays for hospitalization costs.
  • Part B- Pays for physician services, lab and x-ray services, durable medical equipment, and outpatient and other services.
  • Part C- Medicare Advantage Plan (like an HMO or PPO) offered by private companies approved by Medicare.
  • Part D- Assists with the cost of prescription drugs.

Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid (e.g. MSPs, QMBs, SLMBs, and QIs). Medicaid also covers additional services beyond those provided under Medicare, including nursing facility care beyond the 100-day limit or skilled nursing facility care that Medicare covers, prescription drugs, eyeglasses, and hearing aids. Services covered by both programs are first paid by Medicare with Medicaid filling in the difference up to the state’s payment limit.

Amerigroup, Managed Care Organization (MCO) offers Special Needs Plans (SNPs) to those who receive Medicare and Medicaid. These individuals are sometimes referred to as Dual Eligible.

For Dual Eligible members, Medicaid supplements Medicare-covered services by paying for Medicare premiums, members’ cost-sharing requirements and long-term services and supports (LTSS).

Many of the added Amerigroup services make health care more accessible and help individuals live independently in their homes and communities.

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