Benefits

 

Absolute Total Care provides the same benefits as standard Medicaid PLUS MORE!

Absolute Total Care benefits versus Standard Adult Medicaid 
Benefit Absolute Total Care Standard Adult Medicaid
Prescribed Drugs (per month) 4 prescription limit; 3 additional if medically necessary / $3.40 copay 4 prescription limit / $3.40 copay
Family Planning Services Yes Yes
Lab Work & X-rays Yes Yes
English & Spanish Call Center Yes Yes
Physician Visits (per year) Unlimited / $3.30 copay 12 visit limit / $3.30 copay
Hospital Stay (per year) $25 copay inpatient $3.40 copay outpatient / $25 copay inpatient
Home Health Care (per year) 50 visit limit / $3.30 copay 50 visit limit / $3.30 copay
Durable Medical Equipment $.60 – 3.40 copay $3.40 copay
Phone Access 24/7 Yes; Registered nurses through NurseWise No
Care Coordinator Yes No
Education programs for chronic illnesses Yes No
Health programs for pregnancy, diabetes, asthma Yes No
CentAccount (Members earn financial rewards for healthy behaviors) Yes No

*Co-payments: Absolute Total Care does require member co-payments for certain covered and approved medically necessary medical services. The following Medicaid beneficiaries do not have to make co-payments: Children under 19 years, pregnant women, individuals receiving family planning services, institutionalized individuals, individuals receiving emergency services and federally recognized Native Americans.


Absolute Total Care benefits versus Standard Child Medicaid
Benefit Absolute Total Care Standard Adult Medicaid
Physician visits Unlimited / No copay Unlimited / No copay
Prescribed Drugs Unlimited / No copay Unlimited / No copay
Home Health 50 visit limit / No copay 50 visit limit / No copay
Dental Care No. SC Healthy Connections covers all dental benefits. Routine Dental Care through month of 21st birthday
Child Health Screenings (EPSDT) Yes Yes
Family Planning Services Yes Yes
Lab Work and X-ray Yes Yes
Durable Medical Equipment Unlimited / No copay Yes
Vision Care Under 21 only. ATC covers the exam through Opticare. SC Healthy Connections covers materials (glasses, contacts, etc.). Check up and one pair of glasses
Hospital Unlimited / No copay Unlimited / No copay
Phone Access 24/7 Yes; Registered nurses through NurseWise No
Care Coordinator Yes No
Education programs for chronic illnesses Yes No
Health programs for pregnancy, diabetes, asthma Yes No
CentAccount (Members earn financial rewards for healthy behaviors) Yes No

*Co-payments: Absolute Total Care does require member co-payments for certain covered and approved medically necessary medical services. The following Medicaid beneficiaries do not have to make co-payments: Children under 19 years, pregnant women, individuals receiving family planning services, institutionalized individuals, individuals receiving emergency services and federally recognized Native Americans.