Asthma Care Coverage Database | American Lung Association
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    Asthma Care Coverage Database:

    Data Last Updated:

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    Legend

    Coverage Values:

    • Y = Yes, covered for all Medicaid enrollees
    • N = Not covered for Medicaid enrollees
    • * = Coverage varies across state Medicaid plans

    Barrier Values:

    • Y = Yes; barrier exists in all the state Medicaid plans that cover the specified asthma service or treatment
    • N = No; barrier does not exist in any state Medicaid plan that covers the specified asthma service or treatment
    • * = The barrier exists in some of the state Medicaid plans that cover the specified asthma service or treatment
    • NAv = Barrier information is not available for the state Medicaid plans that cover the specified asthma service or treatment
    • N/A = The barrier is not applicable for the specified asthma service or treatment

    Barriers:

    • AL = Age Limit (coverage for individuals under a certain age)
    • AR = Age Restriction (coverage for individuals over a certain age)
    • CO-PAY = Copayment (a fee a patient is responsible for to receive treatment or service)
    • DME = Durable Medical Equipment (treatment or service covered as a DME benefit)
    • EC = Eligibility Criteria (indicates a patient needs to meet certain criteria before receiving a treatment or service)
    • PA = Prior Authorization (service must be approved before patient receives care)
    • QL = Quantity Limit (restricting amount of service or treatment in a specified time)
    • SVL = Specialty Visit Limitation (a service or treatment can only be accessed through a specialist and specialty visits are limited to a set number during a year)
    • ST = Step Therapy (a treatment or service can be received only after other forms of therapy have been tried)
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      Component Coverage AL AR CO-PAY DME EC PA QL SVL ST
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