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 |
| Dental Care |
1 cleaning/exam every 6 months; simple fillings and extractions |
Emergency only |
| Durable Medical Equipment |
$.60 - 3.40 copay |
$3.40 copay |
| Vision Care |
For ages 21 and older, up to $125 for prescription glasses or contacts per 24 months and a 20% discount on amounts exceeding the $125. Member responsible for contact fitting exam. |
Eye exam and glasses following certain surgeries / $3.30 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 |
* Children age 19-20 must pay the same copay as adults
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 |
75 visit limit / No copay |
75 visit limit / No copay |
| Dental Care |
Routine dental care through month of 21st birthday / no copay |
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 |
Eye exam every 12 months. Check up and one pair glasses / no copay |
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 |
* Children age 19-20 must pay the same copay as adults
