Ohio Medicaid is a health care program for Ohio residents with limited income. Once eligibility has been determined recipients will receive a medical card. The medical card is important because it is proof that you can get health care services; it lists the people in your family who have Medicaid and it has important billing information in it. Medical cards are issued in two ways. A fee-for-service card is issued each month or a managed care plan card that is issued one-time. Your health care provider will need to see your card to confirm that you are a current Medicaid recipient. The medical card covers a wide array of medical benefits such as prescriptions, doctor visits, hospital care, surgery, x-rays, physical therapy, prenatal care, ambulance, substance abuse services, dental and vision, long term health care, and home and community services. For general information on Ohio Medicaid click download the JFS – 08211 OH Medicaid General Information guide.
To apply for Medicaid On-line, please visit http://ODJFSBenefits.ohio.gov or download the JFS – 7200 Application for Benefits form to print an application to complete and return to our office at OCDJFS, 8043 West State Route 163, Suite 200, Oak Harbor, OH 43449. Download the JFS – 08102 Medicaid Consumer Guide to view the Medicaid Consumer Guide.
Covered Families and Children is a federally funded initiative that includes Healthy Start and Healthy Families Medicaid. These programs provide services to children younger than 19, pregnant women, and families, including parents and children. The family size and income will determine if the family is eligible for Healthy Start for their kids or Healthy Families for the entire family. To apply for these On-line, please visit http://ODJFSBenefits.ohio.gov. To print an application and mail or fax to our office download the JFS – 7216 Healthy Start Application.
For children up to age 19 and pregnant women the income eligibility guideline is 200% of the Federal Poverty Guideline.
For families including parents the income eligibility guideline is 90% of the Federal Poverty Guideline. For individuals who are at least 19 years of age, but not yet 21 the countable income must not exceed the Ohio Works First (OWF) payment standard for the appropriate household size. If the 19-21 year old is living with siblings and parents that family income is taken into consideration when determining eligibility.
|OWF Payment Standard
The Family Planning Services medical card is available for individuals who do not qualify for any category of Medicaid. This program is a limited-benefit Medicaid program that provides services for the prevention of or delay of pregnancy and for the diagnosis and treatment of sexually transmitted infections. The program is available to both men and women who apply for Medicaid. Services covered under Family Planning include, but are not limited to birth control and contraceptive devices, sexually transmitted infections tests and treatment (except HIV and Hepatitis B), screenings for cervical cancer and/or mammography (when indicated by a breast exam during a routine or periodic family planning visit. To be eligible for this program, individuals must have income at or below 200% of the Federal Poverty Guideline. Download the Federal Poverty Guideline (FPG) from the forms bin at the top of this page.
Individuals who are age 65, blind or disabled may be eligible for A, B, D Medicaid. There are resource and income requirements that must be met in order to qualify. The resource limit for a single individual is $1,500 and for a couple is $2,250. Examples of resources include bank accounts, life insurance policies, trusts, CDs, etc. Income is compared to a need standard for an individual or couple depending on the circumstances. The individual standard is $622 and the couple standard is $1,066. Some individuals may meet the qualifications for Medicaid except their income is too high. The Spend-down program is available for those situations. Individuals must incur costs for medical services that equal the spend-down amount before they are eligible for Medicaid for that month. Incur means that you received medical services and are responsible for payment. Individuals can also Pay-in their Spend-down amount each month with a check or money order to qualify for Medicaid. Once the Spend-down amount is met the Medicaid card is good for the remainder of the month. For general information about Medicaid Spend-down download the JFS – 08032 Medicaid Spend-down sheet from the forms bin above.
Medicaid Buy-in for Workers with Disabilities (MBIWD) is a program that provides health coverage to working individuals with disabilities. To qualify you must:
- Be 16-64 years old
- Be disabled as per Social Security Administration or as determined by Ohio Medicaid
- Be employed in paid work
- Pay a premium (if applicable)
- Meet certain basic requirements and financial criteria
If you are a Medicaid recipient you can contact the Customer Service unit at 330-424-1472 to learn more about the program.
The Medicare Premium Assistance Program is available to help people eligible for Medicare and who have limited income and assets to get help paying the cost of one or more of the following:
- Medicare premium(s)
- Medicare deductibles
- Medicare coinsurance
Different levels of assistance are available depending on income. For more information about the Medicare Premium Assistance Program download the JFS – 08058 Medicare Premium Assist Program form from the forms bin above. To apply online go to http://ODJFSbenefits.ohio.gov or download the JFS – 7103 Medicare Premium Assistance Application. After you complete the application please mail or fax it to our office for processing. An interview is not required for this program.
The state has two programs that are part of the Ohio Department of Health’s Breast and Cervical Cancer Project (BCCP). These programs work together to provide screening services and health care coverage to eligible women. Women who are diagnosed with cancerous or precancerous conditions through the BCCP may be eligible to have their treatment and other healthcare needs covered by Medicaid. To learn more about enrolling contact the Ohio Department of Health Regional Office in Steubenville at 1 (800) 921-5151. You can download an application by clicking on the JFS – 07161 OH Breast & Cervical Cancer Medicaid Application in the forms bin at the top of the page. You can return the completed application to your BCCP case manager at the regional office or bring in to our office and we will fax the application to your BCCP case manager for you.