Non-Traditional Medicaid Plan
Utah Medicaid Program

On July 1, 2002, a new Medicaid Program began. The program, called the Non-Traditional Medicaid Plan, is for an adult who could qualify for Family Medicaid because he or she has a dependent child. Instead of Family Medicaid, adults in one of the groups listed below may qualify only for Non-Traditional Medicaid
• A parent age 19 through 64.
• A parent who receives only Medicaid and parents who also receive cash assistance from the Utah Family Employment Program (FEP).
• A parent who moves from the Family Employment Program to a job and receives transitional Medicaid.
• A parent who pays a spend down to be eligible for Family Medicaid.

Non-Traditional Medicaid has fewer benefits and a higher co-payment and co-insurance than Traditional Medicaid. Children and adults who are disabled, blind, age 65 or older, or pregnant may continue to qualify for Traditional Medicaid.
The Non-Traditional Medicaid card is blue.
In July 2002, Non-Traditional Medicaid Services are listed below. The Medicaid agendy has the right to change the services offered. The Medicaid Provider will let a patient know what services are covered by the Non-Traditional Medicaid Plan.
• Inpatient, outpatient, and emergency department services in an acute care general hospital
• Physician services
• General preventive services and health education given as part of regular office visits
• Family planning services consistent with current Medicaid policy
• Laboratory and radiology services consistent with current Medicaid services
• Pharmacy, with limitations for this plan
• Dental Services, limited to relief of pain and infection
• Vision services, limited to examinations
• Mental health with limitations
• Substance abuse services with limitations
• Physical therapy, occupational therapy, chiropractic services with limitations
• End State Renal Disease - dialysis consistent with current Medicaid policy
• Home health services consistent with current Medicaid services
• Hospice Services consistent with current Medicaid Services
• Medical supplies and equipment consistent with current Medicaid services
• Sterilization and/or abortion based on medical necessity and federal and state
regulations, consistent with current Medicaid policy
• Organ transplants, limited for this program
• Emergency Transportation services, limited to ambulance for medical emergencies only
• Outside medical services in free standing surgical center, emergency centers (InstaCare type), or birthing centers if chosen by the Plan administrators
• Targeted Case Management for the homeless, consistent with current Medicaid policy
• Targeted Case Management for HIV/AIDs, consistent with current Medicaid policy
• Interpretive services, provided by entities under contract to Medicaid

The Non-Traditional Plan does not cover (as of July 2002):
• Allergy testing and injections
• Non-emergency transportation, including bus passes, taxi, and vans
• Speech-language and audiology services