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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)
  • 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)
  • ST : Step Therapy (a treatment or service can be received only after other forms of therapy have been tried)

Other

  • + = : either all plans have no quantity limit or at least two inhalers per month or at least 2 valved-holding chambers per year are covered by all plans>
 
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Component Coverage AL CO-PAY DME EC PA QL ST
                 
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