Medicaid and Affordable Care Act
Medicaid Application Process
Medicaid Coverage - Mandatory
Medicaid Coverage - Optional
Medicaid Dental Coverage
Medicaid Nursing Home
Medicaid & Health Care Reform
State Medicaid Programs
State Medicaid Programs List
Published:Fri, 25 Oct 2013 08:58:30 -0700
WASHINGTON, Oct. 25 (UPI) -- Officials say a spike in Medicaid enrollment may threaten the entire healthcare system if more healthy people don't sign up for private healthcare......
Published:Fri, 25 Oct 2013 09:10:57 -0700
Officials say a spike in Medicaid enrollment may threaten the entire healthcare system if more healthy people don't sign up for private healthcare plans.......
Published:Wed, 23 Oct 2013 09:45:34 -0700
By Mary Wisniewski (Reuters) - Six Ohio Republican lawmakers have filed a lawsuit to challenge Governor John Kasich's plan to expand Medicaid coverage for the poor under Presi......
Published:Wed, 23 Oct 2013 07:07:00 -0700
Core administrative expenses of selected Medicaid plans grew by 2.7% per member per month . This increase was sharply lower than last year and resumes a multi-year trend of modest......
Published:Thu, 24 Oct 2013 11:50:20 -0700
Despite glitches of its own with long forms and delayed queries, Colorado Medicaid has a boom of applications for its half of the Affordable Care Act launch receiving troubled rev......
Medicaid in Ohio
Ohio Medicaid is a jointly-funded federal and State health care program for eligible low-income residents and people that are in need of medical assistance.
The Ohio Department of Job and Family Services (ODJFS) administers the Medicaid program in Ohio.
Residents of Ohio that are eligible for Medicaid can receive all medically necessary services. The State of Ohio can not limit the number of people that are eligible for Medicaid or deny medical access to those in need.
The Ohio Medicaid program provides health care coverage for children, families, pregnant women, adults age 65 and older, and individuals with disabilities. Some people that receive Medicaid may be required to pay co-pays or monthly premiums for some medical services.
Ohio Medicaid processes more than 115 claims per minute, pays for one in every three births, and pays for 70 % of all nursing home costs. Ohio spends $15.4 billion on Medicaid per year.
To receive Medicaid in Ohio, you must meet certain requirements. You must be:
1. A citizen of the United States or meet Medicaid citizenship requirements.
2. Be a resident of Ohio.
3. Have a Social Security number or have an application pending.
4. Meet Medicaid financial requirements.
Groups of people that are covered by Ohio Medicaid include:
1. Aged, blind and disabled (ABD) - This includes residents of Ohio that are age 65 or older and individuals that are any age but have a disability. Even if you are within this ABD group, you must meet the low-income standards to be eligible for Medicaid.
2. Children and Families - Families, children (up to age 19) and pregnant women with limited incomes are covered through Medicaid under Healthy Start or the Healthy Families programs. Certain children aging out of the foster care system at age 18 may continue receiving health care coverage until age 21 at no cost to them.
Families participating in the Ohio Works First (OWF) cash assistance program are automatically covered by Medicaid. Families who leave OWF for employment are eligible for 6-12 months of coverage during that transitional period.
3. Medicaid Spenddown program - In certain situations, individuals applying for ABD Medicaid meet eligibility requirements except your income is too high. You can participate in the Medicaid Spenddown program. A spenddown is like a monthly deductible determined by the Medicaid caseworker.
In order to qualify for Medicaid coverage during a certain month, you must submit proof of medical expenses that equal the spenddown amount. You can also choose to pay your spenddown directly to the county office. Once the spenddown is reached, you are then eligible for Medicaid for the rest of the month.
4. Medicaid Buy-In for Workers with Disabilities (MBIWD) - MBIWD provides health care coverage to working Ohio residents ages 16 to 64 who are disabled. MBIWD was created to encourage residents of Ohio with disabilities to work and still keep your health care coverage.
To qualify for MBIWD, your gross countable income must be no more than 250% of the federal poverty level (FPL), and you must also have resources that do not exceed $10,580. Monthly premiums are required for those eligible for MBIWD with an annual gross income greater than 150% FPL.
5. Medicare Premium Assistance Program (MPAP) - Low-income Medicare beneficiaries can receive help from Medicaid with all or part of your Medicare cost sharing expense. This includes Medicare Part A and B premiums, co-insurance and deductibles. Different levels of assistance are available depending on your income.
6. Breast and Cervical Cancer Project (BCCP) - Medicaid also provides health care coverage to eligible women screened through Ohio Department of Health’s Breast and Cervical Cancer Project. To qualify for ODH’s BCCP, women must have income below 200% FPL, be between the ages of 40-65 and uninsured.
Once screened and diagnosed as having breast and/or cervical cancer, BCCP Medicaid may be available to women who are in need of treatment services. Women who are covered by BCCP Medicaid have access to the full Medicaid benefit package in addition to their cancer treatment.
How do you get Ohio Medicaid services?
After you have applied and been accepted to receive Medicaid, you can get health care services from a Medicaid provider who accepts Medicaid as health insurance. This is known as fee-for-service Medicaid. You may be required to get your services from a Medicaid managed care plan. Both fee-for-service Medicaid and the managed care plans provide all medically necessary primary, specialty and emergency care, and preventive services.
Ohio Medicaid also provides both home health care and facility-based services if you are requiring long-term care services. Home care services allows you to remain in your home and community. Long-term care services are also available if you need care in nursing homes and facilities for persons with mental retardation. Alternatives to institutional care are offered through home and community-based services waivers (e.g., PASSPORT, Ohio Home Care).
What does Medicaid help pay for?
The Ohio Medicaid program includes coverage mandated by the federal government as well as optional services that the State of Ohio has elected to provide, known as Medicaid waivers.
Some Medicaid services are limited by dollar amount, the number of visits per year, or the setting in which they can be provided. With some exceptions, all medically necessary services are available to all Medicaid consumers.
Ohio Medicaid Application
If you are a resident of Ohio and are interested in Medicaid, you can use this link to apply for Ohio Medicaid.
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The official U.S. Government Medicare Web site is cms.gov.