In states that take up the Medicaid Expansion, newly covered Medicaid beneficiaries will receive an “Alternative Benefits Package” (ABP) that includes the EHBs.
The ABP will be determined by the states, and may be modeled after the state’s chosen benchmark plan for the Insurance Exchange, or the state’s traditional Medicaid benefits package. However, the ABP will be measured against the benchmark plan for adequacy.
New Medicaid patients that are determined to be “medically frail” will have the option of enrolling in the traditional Medicaid benefits package, or the ABP.
Patients with HIV, hepatitis, and other chronic conditions will likely fall under the “medically frail” definition. This will give them the option of choosing the more comprehensive coverage option of the two.