Health Assistance/Medicaid

The Medicaid program in Ohio provides medical coverage for certain qualifying individuals and families with limited income. To qualify for Medicaid a person must be a U.S. citizen or meet Medicaid citizenship requirements, an Ohio resident, have or obtain a Social Security number, and meet financial requirements, which vary depending on the program.

To find examples of what a family can make per year and still qualify for Medicaid, click here, or go to the Federal Poverty Guidelines.

For more information, you may read the Medicaid Eligibility Manual.


The following individuals may qualify for Medicaid coverage in Ohio –

• Children up to 19 years old
• Parents or caretaker relatives of children up to 19 years old
• Some 19 and 20 year olds
• Adults up to age 64 living at or below 138% FPL
Pregnant women
Some women with breast and/or cervical cancer
Adults aged 65 and older 
• People with disabilities, including blindness as determined under the Social Security rules
Some immigrants may be eligible for Medicaid 

  • There are some programs to help immigrants who are not eligible for Medicaid. Learn more here.

 


HOW TO APPLY FOR COVERAGE
Step 1
There are lots of ways you can apply. First, research your options. Which Ohio Medicaid program would you like? Then start the application process. You can apply online, in person, by mail, or on the phone.

Step 2
Read the application carefully. Attach copies of your proof of income, resources (such as cash, savings, checking, real property, stocks, bonds, etc.), proof of citizenship or alien status, pregnancy if applicable, and other insurance you may have. If you are applying because you are age 65 or older or disabled, you will need to provide proof of your age or disability.

Step 3
Sign and date the application and send the application and any additional materials to your local county Job and Family Services office. You may mail, fax or drop off the application. You may also have an authorized representative apply on your behalf.
An authorized representative is an individual, age 18 or older, who stands in your place. You must provide a written statement naming the authorized representative and the duties the authorized representative may perform on your behalf. All notices and correspondence issued by Medicaid must be issued to both you and the authorized representative.

Step 4
Along with your application, you have an opportunity to register to vote or change your address. Please complete the Voter Registration Form and submit it with your application. We will submit your form to the local Board of Elections. If you need assistance completing this form, please ask for help at the Job and Family Services office. Completing the voter registration form is optional and is not required to apply for any public assistance program.
From here, you can complete an application for coverage online or read about what to expect after you apply.


WHAT HAPPENS NEXT?
Step 1: Case Review
After you apply, you may get a letter asking for more information if we need it. If you need help getting the information, ask your case worker. After the county office has everything, it may take up to 30 days to make a decision. If you are applying for disability benefits, it can take longer.

Your case will be reviewed every 12 months. If there are any changes in your household that might affect your eligibility in between your review times, you need to let your case worker know within 10 days.

Step 2: Approval
When you are first approved for Medicaid you are automatically enrolled in our Fee-For-Service coverage. You will get a letter in the mail with your Medicaid card and can start using services right away. If you stay on the Fee-For-Service plan, you will get a new card every month.

Ohio Medicaid has a statewide network of providers including hospitals, family practice doctors, pharmacies and durable medical equipment companies. Under the Fee-For-Service plan these providers bill Medicaid directly for health care services they provide to you. You should ask the provider if they accept Medicaid before you schedule an appointment.

Step 3: Managed Care
Most people are automatically approved for Medicaid Managed Care coverage. Shortly after you get on Medicaid you will get a letter asking you to choose a Medicaid Managed Care plan (MCP). Visit or call the Consumer Hotline to find out which plans are available in your area. Below are the links to the five managed care plans for more information. If you don’t choose a plan, we will choose one for you.
Description: Click here to visit the Buckeye Community Health Plan web site.Description: Click here to visit the CareSource web site.Description: http://medicaid.ohio.gov/portals/0/Images/MCP/Molina-small.jpgDescription: Click here to visit the Paramount Advantage web siteDescription: Click here to visit the United Health Care web site
The best way to enroll in Managed Care is online with the Consumer Hotline.


Step 4: Getting Health Care
Managed Care acts just like regular private health insurance. Once you are enrolled in a Managed Care plan, you will get a new card in the mail. Here’s what they look like.
Description: Example medical card for Buckeye Community Health PlanDescription: Example medical card for Molina Health PlanDescription: Example medical card for CareSource
Description: Example medical card for Paramount Advantage Health PlanDescription: Example medical card for United Health Care Health Plan
Managed Care plans send one permanent card when you enroll. Keep this card for as long as you are on the plan. The plan will also send you information on your doctors, health services and scope of coverage from your plan.

 

 

LINKS
ObamaCare Facts: Facts on the Affordable Care Act
HealthCare.gov
The YouToons Get Ready for ObamaCare