Benefits at a Glance
Utah Molina Medicaid
For a full list of benefits information, please read your Member Handbook or call Member Services at (888) 483-0760.
Covered Services are marked with "X."
Services that need approval in advance are marked "+."
| Services You May Need | Traditional Utah Medicaid |
|---|---|
| Abortion | X + |
| Autism services | X + |
| Diabetes education | X |
| Medical supplies/equipment | X |
| Durable Medical Equipment (DME) | X + |
| End state renal disease - dialysis | X |
| Home health services | X + |
| Hospice services (up to 30 days) | X + |
| Skilled nursing facility, intermediate care facility, longterm acute care (up to 30 days) | X + |
| Family planning | X |
| Lab/X-ray | X |
| Inpatient hospital services | X |
| Outpatient hospital services | X |
| Emergency department services | X |
| Physician services | X |
| Podiatry services | X |
| Preventative services (mammograms, Pap smears, prostate exams) | X |
| Physical therapy (PT)/occupational therapy (OT) | X (Approval is needed after 12 combined visits per calendar year) |
| PT/OT in home services | EPSDT or Early Periodic Screening, Diagnosis and Treatment (previously called CHEC) and pregnant women only |
| Prenatal services (care coordination, prenatal and postnatal home visits, group education, nutritional assessment, counseling) | X |
| Private duty nursing | X + |
| Speech and hearing Services | EPSDT or Early Periodic Screening, Diagnosis and Treatment (previously called CHEC) |
| Hearing aids and batteries | EPSDT or Early Periodic Screening, Diagnosis and Treatment (previously called CHEC) |
| Speech augmentative communication devices (SACDs) | X + |
| Sterilizations | X + |
| Substance use treatment | X |
| Organ transplant | X |
| Vision (VSP) | |
| Routine eye exam | X |
| Eyeglasses (frames and lenses) | EPSDT or Early Periodic Screening, Diagnosis and Treatment (previously called CHEC) and pregnant women only |
| Contact lenses | EPSDT or Early Periodic Screening, Diagnosis and Treatment (previously called CHEC) and pregnant women only + |
| Carved Out Services (not covered by Molina Medicaid) | ||
|---|---|---|
| Dental | Contact State Medicaid | Contact State Medicaid |
| Targeted case management T1017, T1023 | Contact State Medicaid | Contact State Medicaid |
| Ambulance transportation | Contact State Medicaid | Contact State Medicaid |
| Nursing facility, Long Term Care (longer than 30 days) | Contact State Medicaid | Contact State Medicaid |
| Specialized mental health services | Prepaid Mental Health Plan | Contact State Medicaid |
| Transportation | Contact State Medicaid | Contact State Medicaid |
| Chiropractic services | Contact State Medicaid | Contact State Medicaid |
| Apnea monitors | Contact State Medicaid | Contact State Medicaid |
