Table of Contents
What does my SC Medicaid cover?
Adults: Medicaid covers preventative dental care including diagnostics, extractions, fillings and an annual cleaning, up to a maximum benefit of $750 per year. Children: A dental exam every six months is covered. Fillings are also covered.
What is covered services in Medicaid?
Mandatory benefits include services including inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others. Optional benefits include services including prescription drugs, case management, physical therapy, and occupational therapy.
How many ultrasounds does SC Medicaid cover?
Current Medicaid policy allows one complete ultrasound per pregnancy. Additional ultrasounds are covered, based on medical justification with the results documented in the patient’s chart.
What is non covered services in medical billing?
Definition of Non-covered Charges In medical billing, the term non-covered charges refer to the billed amount/charges that are not paid by Medicare or any other insurance company for certain medical services depending on various conditions. Filing claims for non-covered charges are likely to result in denial of claims.
Can we bill Medicare patients for non covered services?
Under Medicare rules, it may be possible for a physician to bill the patient for services that Medicare does not cover. If a patient requests a service that Medicare does not consider medically reasonable and necessary, the payer’s website should be checked for coverage information on the service.
Does Medicaid cover root canals in SC?
There is a $3.40 copayment for adult Healthy Connections Medicaid members toward the cost of preventive care. The new benefit does not cover crowns, root canals, periodontal scaling and root planing, teeth whitening or dentures.
Does SC Medicaid pay for root canals?
Does Medicaid cover eye exams in SC?
Medicaid will pay for one eye exam and one pair of glasses for a child once a year. Adults can get an eye exam every year and a pair of glasses following cataract surgery.
What is the difference between a covered service and a non-covered service?
Whether or not a service is covered is dependent upon your insurance policy. For example, Medicare will pay for an annual physical exam as part of a covered service. However, Medicare does not pay for normal dental procedures. Non-covered services are services patients are responsible for paying on their own.
What is a non-covered benefit?
A non-covered benefit is a health service that your health plan will not pay, and you must cover the cost at 100%. The Uniform Summary of Benefits and Coverage (SBC), a form that every health insurer provides, has a list of common medical services, and can show you your costs under your health insurance plan.
What are non-covered services?
A non-covered service in medical billing means one that is not covered by government and private payers.
Does Medicaid pay for braces in South Carolina?
Orthodontics. Orthodontic Services are not a covered service by Medicaid.
Does Medicaid cover wisdom teeth removal in SC?
Emergency dental services are available to all Medicaid beneficiaries. Oral surgery services are covered as part of emergency dental services.
How do I change my SC Medicaid plan?
To log in, use your Member ID and PIN. Click “Continue,” and follow the easy instructions to change your health plan and doctor. Or call our Customer Service Center at 1-877-552-4642.