Wraparound services are optional services provided by Medicaid to supplement care and services mandated under Medicaid. These include caregiver support, prescription drugs, home care, dental, vision, and hearing care, that keep older adults healthier and allow them to avoid or delay nursing home care.
Deeper Dive
Wraparound services help low-income seniors — the dual eligibles who get coverage through both the Medicare and Medicaid programs. Medicare is the primary payer and covers medical acute and post-acute care, including skilled nursing facility services and home health care. Medicaid “wraps around” Medicare coverage by paying Medicare premiums and in most cases, cost sharing. Most beneficiaries can also receive Medicaid benefits that Medicare does not pay for.
Dual-eligible individuals are generally low income, have many chronic conditions and/or disabilities. Without Medicaid wrap around coverage, some seniors may not get important health care such as eye exams, oral health, help with activities of daily living like bathing and dressing, or have to either pay out of pocket. They may be forced to choose between paying for medications or groceries, or end up in a nursing home. Medicaid coverage of these services varies widely across states, potentially leading to variation in access and use among dual-eligible individuals, according to a KFF brief.