This list is split into two groups. The first group defines basic health services covered under most basic state Medicaid plans. The second group covers services that many people with disabilities need, which are usually covered by waivers.
This list does not cover every possible service, but gives definitions for common services. Not all services will be available in all states and territories, since Medicaid guidelines vary. Make sure to look at your state’s options to see what you can get.
Basic Medical Services (state plan services)
- Clinic Services
- Disease Management
- Disposable Medical Equipment and Supplies
- Durable Medical Equipment
- Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
- Emergency Services
- Family Planning
- Health Education
- Hearing / Audiology
- Mental Health
- Physical Therapy
- Prosthetic or Orthotic Devices
- Substance Abuse Treatment
Services for People with Disabilities (waiver services)
- Activities Therapy
- Assistive Technology and Adaptive Equipment
- Behavioral Health Services
- Diagnostic Services
- Habilitation Services
- Long-Term Care
- Nursing / Skilled Nursing
- Occupational Therapy
- Speech, Hearing and Language Therapy
- Assisted Living
- Child Care Supports
- Chore Services
- Companion Services
- Environmental and Home Adaptations
- Home Delivered Meals
- Home Health Care / Domiciliary Services
- Homemaker Services
- Personal Assistance Services / Personal Care Services
- Respite Care
- Supervised or Supported Living
- Community Specialist Support
- Consultation Services / Counseling
- Financial Assessment
- Integrated Supports / Support Coordination
- Support Broker
- Self-Advocacy Training
- Targeted Case Management / Case Management
- Transition Services
Service Terms and Definitions:
Activities Therapy can be done one-on-one with a therapist or in groups. This kind of treatment helps encourage creativity and positive thought processes in patients by teaching them how to dance, play an instrument, or do artwork. This helps provide both a physical challenge and a mental one, and gives participants something to enjoy and be proud of.
These are things that are designed to assist people with the activities of daily life—things like moving around the house and the community, communicating with other people, or dressing, feeding, and grooming yourself. Programs that cover this will often help you select, buy, and learn to use this equipment, as well as help you pay to fix it if it breaks or needs to be replaced.
Adult day care is a daytime program for adults with disabilities outside of their homes. These programs can focus more on medical care or more on socializing. They can provide meals, activities, medical care, and outings in the community.
Assisted living is for people who need help with daily activities such as dressing, eating, taking medicine, bathing, or using the bathroom. This usually takes place in a residence designed for people with these needs, so that staff can be with them at any time. However, this does not need to be a nursing home anymore. There are many options for attended care residences of different sizes that provide different levels of service.
Behavioral health means any kind of behavior that is related to health, especially preventing sickness and engaging in healthy actions. This often refers especially to mental health and often includes drug or alcohol abuse as well, and can also include Cognitive Behavioral Therapy (CBI)—talk therapy.
Child care supports can help individuals with I/DD care for their children or help parents of children with I/DD by taking some child care responsibilities off their hands. This child care could take place in the home, outside the home, one-on-one or in a group, or while the parents are at home.
Chiropractors work on back pain and spine problems. By adjusting your back, chiropractors can help fix pain in many other areas of the body.
This service can help with household chores both inside and outside the house. It can be used for everyday chores like cooking and cleaning, or seasonal chores like minor home repairs or lawn care.
These are general medical services usually relating to primary care. Primary care is things like regular checkups, minor illnesses, and vaccinations. Unlike hospitals, these are not specialized services and patients usually do not check in to stay overnight.
Community specialists can help manage your life outside the home. This can include helping find and keep a job, a day program or caretaker, social events or volunteer opportunities, transportation, etc.
Companion services will provide someone to stay with you in your home for any amount of time you need, whether this is for a few hours a week or all the time. Companions will help with non-medical chores like laundry, cooking, transportation, bathing and dressing, and also provide friendship and conversation so that people can enjoy living in their homes.
Consultation services offer a number of different options for working on mental health or behavioral issues, or feelings of depression, stress, or concern. These services might include regular talk therapy, play therapy or activity therapy, family therapy, or medication management.
For people who speak a language other than English (or whatever language the doctor speaks), it is often good to have an interpreter who speaks your language and understands your culture. This can help you talk with doctors and social workers so that you can understand your care and tell providers what you need.
Day care can be for adults or children, but these programs will offer supervision and activity for people with I/DD outside their homes during the day. This might be while a parent or caretaker is at work, or it might just be an opportunity to get out of the house and socialize.
Dental services take care of your teeth, gums, and mouth.
These programs provide clinic-based day care for people with I/DD. These include things like early intervention and preschool programs as well as adult development for older individuals.
These services try to determine what medical issue or disability a person has, and what causes it. This will help doctors know what other treatments or services this person needs.
Disease management is a term for integrated care of a chronic disease where a large part of the work is self-care by the patient. For example, this would mean exercising and eating the right foods for someone who is diabetic or someone who has heart disease.
This is a group of medical supplies that you use and then throw away. These are things like bandages and wound dressings, incontinence supplies, and nutritional products.
This is anything that is used to make home life easier or improve your ability to move around. This includes power chairs and wheelchairs, hospital beds, monitors for blood or heart rate, and oxygen systems.
This refers to basic preventive medical care like regular check-ups, well visits, physicals, dental exams, and vision and hearing checks.
This usually refers to an ambulance and emergency room care in case of a serious and unexpected illness or injury.
This service can make changes to your home or living space to make moving around or completing daily tasks easier. These changes can include minor construction like installing ramps or railings or widening doorways, or just rearranging things so they are easier to see, reach, and use.
These services are for people who are having sex or thinking about having children. They can help you have children or help you not have children if you don’t want to. They can also help with care if you are pregnant.
These services can help you manage your money better. A financial planner can look at your accounts and help you organize, budget, and decide how to spend your money on health care and other necessities. Sometimes, they will pay bills for you if you are directing your own services.
These services are for young people and adults with disabilities, and focus on teaching goal-oriented skills like how to complete daily living tasks, how to pursue work and educational opportunities, and how to use a computer. These services are usually provided in a community setting or day program. However, Residential Habilitation includes home-based tasks and can take place in the home.
These services help people stay healthy by teaching them healthy behaviors and facts about common risks. These services try to get you to act in a healthy way and avoid health issues before they come up.
Audiology is the science of hearing. This treatment is to help prevent and address hearing loss and related disorders, including balance problems.
These programs can deliver prepared food to people with I/DD who are living in their homes, to ease the load of cooking on residents or their caretakers.
This service is known by many names in addition to the two above, including home care, formal care, social care, or skilled nursing. It means any care given to a person with I/DD in their home by a healthcare professional. However, these terms are sometimes also used to talk about informal care and support given by a non-medical caretaker, family member, or friend that also takes place in the home. If you see any of these terms, make sure to ask specifically what kinds of services are included and what kinds are not.
Homemaker services provide both childcare and help with household chores for families that are under a lot of stress. Homemakers can also be advocates and counselors for family members.
Hospice care is for people near the end of very serious illnesses who are very likely to die. It is end-of-life care that tries to take away pain and keep patients comfortable once their illnesses can no longer be treated.
Hospital services take place in a hospital or related clinic. They are specialized services, which can make them very expensive. Hospital care often means that patients have to stay in the hospital while they get treatment.
This means getting shots or other treatments that help prevent you from getting sick. This includes vaccines and booster shots, and yearly flu shots.
Integrated supports combine a variety of services for people with I/DD. These programs might include adult day care, supported employment, and residential services, but also can include things like counseling, assistance with chores and personal care, fitness activities and transportation.
You will probably never see laboratory services at work. But every time you get blood drawn or give a urine sample, for example, laboratory testing is what gives you and your doctors test results.
Long-term care is a term used to talk about the combination of services, both medical and non-medical, that people with disabilities will need over the course of their lives. It refers mostly to activities of daily living like dressing, bathing, eating, and using the bathroom.
Mental health treats things like stress, anxiety, depression, anger, and more serious things like schizophrenia and other mental illnesses. Services might be things like talk therapy or medication to help with symptoms.
This is the level of care that people receive in nursing homes. This service includes many other services, including therapies, social worker services, recreation, and transportation. The title Nursing or Skilled Nursing, however, shows a level of care that not everyone who uses these services needs.
Occupational therapists help people with I/DD with activities of daily living, with the goal that they will enjoy more freedom and independence as well as healthier lives.
These are similar to home health care services except that they often do not include any kind of medical treatment and are not performed by health care professionals. Personal assistance or personal care is focused on helping with activities of daily living and doing basic household chores like laundry, cooking, and organizing.
This service provides medication to help treat medical conditions. Usually this will mean prescription medications that your doctor recommends for you.
Physical therapy focuses on promoting health and independence by making sure bodies can move well and stay strong. This can help with mobility and allow people to have more active lifestyles, and let them depend less on mobility aids.
A physician means any doctor, but physician services refers to your regular doctor. If you are sick and need to be seen, or are going for a regular checkup, you will be using physician services.
A podiatrist is a doctor who works with feet and lower legs. There are many things that can go wrong with feet and legs that seem small but can have big effects on your ability to move around. If this happens, a podiatrist can help you.
These programs provide counselors to assist in planning for further education, job searches, and possible employment options for people with I/DD. Counselors can help find training courses, apprenticeships, and job openings as well as assist with interviewing and resume writing skills.
Prosthetic devices (called prostheses) replace body parts that are missing, like replacement limbs. Orthotics are braces that support your back and torso if you have back pain or spine problems (like scoliosis, a curved spine).
Respite care is designed to give family members or other permanent caretakers of children or adults with I/DD a short break from their duties. This helps to support the primary caretaker and maintain the happiness of people with I/DD and their families in their homes. Respite care, then, is care for the person with I/DD and for the caregiver.
Self-advocacy is when people with disabilities ask for, and argue for, what they want. It is an idea that says people with disabilities should have control of their own lives, make their own decisions, and get the supports they need. This training can give you strategies to make your voice heard to people who can help you.
Speech, hearing and language therapy addresses difficulty with talking and hearing. Speech therapy works on problems forming sounds or pronouncing words correctly, while language therapy deals with trouble understanding what people are saying or forming your own expressions out loud. People with autism often use this kind of treatment.
This treatment is for people who misuse drugs or alcohol. It can mean entering a rehab facility, going to support groups, or going through other treatment programs with a doctor or therapist.
Supervised living arrangements are for one or more people with disabilities living together in a household, usually in a residential neighborhood. These supports make help available around the clock if it is needed, but assistance is based on the capabilities of each member of the household.
A support broker is someone who will work with you to get services you need, make a plan based on the way your life is now, and decide what is best for you to do in the future based on your goals. Support brokers can help you make connections and get access to resources in the community.
Supported employment services give people with I/DD what they need to work in a community workplace. These things might include a job coach, job training, transportation, or assistive technology. Supported employment usually refers to helping an individual find a job and keep that job.
A case manager is someone who helps an individual with medical needs get access to the right programs, offices, agencies, and doctors to meet those needs. A targeted case manager for I/DD is someone who works only with people with I/DD, so that person has specific knowledge about which services people with I/DD might need and how to set them up.
Enhanced transition programs can provide support for people who reside in institutions or nursing homes and want to transition to living in the community. Usually they will provide a counselor to help set up community-based services, housing, and support. These kinds of services can also be provided for people who are transitioning from school to work.
Non-emergency transportation is almost any transportation that takes place outside an ambulance. Often this service is only for transportation related to medical needs, like doctor’s appointments or therapy sessions, but transportation can also be arranged for day care, errands, or other activities outside the home.
This service is to help correct differences in vision, by using eyeglasses or contacts or other treatments.
X-rays are images that can show doctors the inside of bodies. They use these images to spot broken bones or other problems they can’t see through your skin.