Page 1 GAO-24-106960 Medicaid Coverage of Menstrual Products
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k of access to affordable menstrual products (e.g., tampons, pads, menstrual
cups, and period underwear) may affect school participation, employment, and
mental and physical health. Advocates for increasing access to menstrual
products have highlighted this issue as a public health concern. Public
assistance programs that serve low-income individuals, such as Medicaid, may
not routinely cover the cost of menstrual products.
1
Within broad federal
requirements, states have flexibility in how they design and administer their
Medicaid programs, including options to provide services that address health-
related needs. For example, states may contract with health plans to deliver
Medicaid benefits to beneficiaries—an arrangement known as managed care—
and the plans may elect to provide additional services.
We were asked to examine states’ coverage of menstrual products in their
Medicaid programs. This report describes circumstances under which state
Medicaid programs may cover menstrual products, as well as Medicaid managed
care plans’ coverage of these products across states.
• Coverage for menstrual products is not a Medicaid benefit. However,
M
edicaid managed care plans may voluntarily cover some costs of menstrual
products as an extra service for eligible enrollees
.
• We found that 25 states had at least one Medicaid managed care plan that
c
overed a range of over-the-counter or personal care items, includi
ng
m
enstrual products, or covered menstrual products specifically up to a s
et
quanti
ty or dollar amount. This coverage was not offered by all the plans i
n
eac
h of these states
.
• C
enters for Medicare & Medicaid Services (CMS) officials reported that s
tate
Medicaid programs have other options to provide coverage of menstrual
products, including seeking federal approval to cover the costs of menstrual
products as part of a demonstration project, though no state has done so.
No. Menstrual products are not a mandatory or optional Medicaid benefit.
2
Federal law specifies Medicaid benefits that must be provided under state
Medicaid plans (referred to as mandatory benefits) and benefits that states may
choose to provide (referred to as optional benefits) for eligible beneficiaries. For
example, mandatory benefits include inpatient and outpatient hospital services;
physicians’ services; laboratory and x-ray services; and early and periodic
screening, diagnostic, and treatment services for eligible individuals aged 20 and
under, among other benefits. Optional benefits include private duty nursing
services, dental services, prescription drugs, and case management services,
among others.
U.S. Government Accountability Office
Medicaid: Menstrual Product Coverage
-24-106960
Report to Congressional Requesters
Is coverage for
menstrual products a
Medicaid benefit
?
