Family Healthcare (FAMIS) Manual

0910.055.30 MC+ Healthcare Coverage (ETMA)

Adults who receive Extended Transitional Medical Assistance will receive a more restricted coverage package than that received by MC+ children and other adults eligible for MAF or TMA. The package includes most of the services covered for adult MAF recipients. The major differences between this package and that received by other adult MAF recipients are:

  • Non-emergency medical transportation is not covered;
  • Vision care is limited;
  • Routine dental care is not covered;
  • EPSDT services for caretaker relatives under age 21 are not provided.

For specific coverage questions, recipients need to contact their health plan, provider, or Recipient Services at 1-800-392-2161.

Cost sharing will be $10 at the time of each provider visit and $5.50 to $7 for each prescription. The co-payment amount is based on the actual cost of the product being dispensed.