Medicaid is a jointly funded state and federal health insurance program that provides affordable basic health services for over 70 million low-income Americans – including one third of people living with epilepsy. Each state administers their own Medicaid program according to certain parameters issued and by The Centers for Medicare and Medicaid (CMS). CMS is a federal agency within the Department of Health and Human Services that serves as the single largest health care provider in the United States. They create policy guidelines, rules, and standards that states must meet; while states have considerable flexibility and control of covering other populations and services not required under federal law. Federal law requires states to cover certain services, such as inpatient and outpatient hospital services, physician services, and laboratory services, for low-income people, families and children, pregnant women, elderly adults, and people with disabilities based on an income threshold. Some state programs cover additional populations and services including prescription drugs, case management, and physical therapy.
The Epilepsy Foundation is committed to ensuring that Medicaid provides adequate, affordable, and accessible health care coverage for people living with epilepsy. Learn more about the advocacy work of the Epilepsy Foundation on the pages below.
Section 1115 Demonstration Waivers
State Medicaid Formularies for Epilepsy Medications