What Is Medicaid Fee-For-Service?

Tag: insurance-and-health-plans

Published: December 12, 2025

Last Updated: January 13, 2026

Summary

Understand fee‑for‑service Medicaid models and how they affect coverage of home medical equipment and supplies.

If you have Medicaid, you may have heard the term “Fee-For-Service.” Ever wonder what that means, and how it affects your health coverage?

Fee-For-Service simply refers to how healthcare professionals receive payment from Medicaid. Here’s a breakdown of how it works and how to use it for medical supplies.

Fee-For-Service means that Medicaid pays doctors and healthcare professionals directly for each service they provide. Here’s a simple example:

1. A Medicaid member visits the doctor for a check-up
2. The doctor charges Medicaid a fee according to the state’s fee schedule
3. Medicaid pays the doctor the fee for that check-up.

Although Fee-for-Service Medicaid pays providers directly, some Medicaid recipients may still have to pay small premiums or copays.

You can receive any medical services that your Medicaid plan covers, so long as the service is medically necessary and prescribed by your doctor.

Absolutely. You can get any medically necessary supplies covered by your Medicaid plan. Here are some of the products you may be eligible to receive:

• Incontinence – Bladder control pads, adult briefs, and more.
• Diabetes – Blood glucose monitors, test strips, and more.
• Wound Care – Gauze, tape, dressings, foam, and more.
• Ostomy – Skin barriers, pouches, wafers, and more.
• Urology – Catheters, lubricant, drainage bags, and more.
• Breast Pumps – Manual and automatic models.

No, not every state offers Fee-For-Service Medicaid. Some states also have Managed Care Plans, or a combination of Fee-For-Service and Managed Care plans. Managed Care means that the state contracts with private insurance companies to provide Medicaid health plans.

To find out if you have a Managed Care Plan or Fee-For-Service, call the number on the back of your insurance card or refer to your plan’s benefit handbook.

To get supplies with your insurance, call us today or enroll online for incontinence supplies. Our team of experts will explain which supplies your Medicaid plan covers. We can also set you up with monthly product deliveries if needed and bill your Medicaid plan for the cost. The process is simple:

• Provide us with some basic information
• We do all the insurance paperwork for you
• Once complete, we’ll ship you monthly product orders covered by your Medicaid plan.

It only takes 10 minutes to get started and could save you hundreds on medical supplies each month.

Living with a chronic condition that requires medical supplies?

Let us help you get the products you need — delivered discreetly to your door.

Many people manage ongoing health conditions, and the right medical supplies can make all the difference. The team at HCD works with you, your doctor, and your insurance plan to support a wide range of needs, including urological, ostomy, diabetes, and wound care. We’ll help ensure you get the supplies you need to manage your condition with confidence.

Call 866-938-3906 to see if you qualify or reach out through our Contact Us form by selecting “An individual looking to see if I or a loved one qualifies for medical supplies.”