How to Get Ohio Medicaid Benefits | Best Answers

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We have scoured the internet to provide all you need to know about the Ohio Medicaid Benefits.

Medicaid is a joint federal-state program that provides health insurance to low-income individuals who meet specific requirements, including kids, pregnant women, the elderly, and individuals with disabilities. Applying for Medicaid live, on the telephone, or online is simple.

This post will teach you all you need to learn about Medicaid in Ohio.

What is the Ohio Medical Program?

Ohio Medicaid is a service for people and families with income and resources that fall within specific parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the Ohio Medical Program?

Ohio Medicaid offers limited Medicare beneficiaries who are not eligible for the entire Medicaid benefit package some partial financial help with Medicare premiums and copayments or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*The Maximum Income Level (Per Year)
1$18,075
2$24,353
3$30,630
4$36,908
5$43,186
6$49,463
7$55,741
8$62,018

*For households with more than eight people, add $6,277 per additional person.

How do I contact Medicaid in Ohio?

Phone

800-324-8680

Mailing Address

Ohio Department of Medicaid, Provider Relations Section, P.O. Box 1461, Columbus, Ohio, 43216-1461.

What are the Medicaid plans in Ohio?

Medicaid Managed Care Program

Foster children, American Indians, and Alaska Natives have the option to voluntarily participate in the state’s current, risky, comprehensive Medicaid Managed Care Program. 

Most low-income children and their families, as well as those Medicaid recipients with disabilities, are compelled to do so. 

The program has been phased in over time by region.

Program for the AllInclusive Care for the Elderly (PACE)

To provide people over 55 who need nursing home-level care and live close to the two participating sites with complete, managed care services, the state also created the Program for All-Inclusive Care for the Elderly (PACE) in 2002.

For more details regarding Medicaid Plans in Ohio, visit here.

How do I apply for Ohio Medicaid?

Call 800-324-8680 to enroll. 

Apply in person at the Ohio Department of Medicaid, Provider Relations Section.

Online:  Download and print the application.

Mail: To  P.O. Box 1461, Columbus, Ohio, 43216-1461.

What is covered by Ohio Medicaid?

Ohio Medicaid covers the following services:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsHospital outpatient care
Home health careX-rays and other radiology services

Can I have both Ohio Medicaid and Medicare?

Members of a MyCare Ohio plan are eligible for both Medicare and Medicaid benefits. Members are eligible for additional plan features, including enhanced transportation services and no copayments for prescription medicines reimbursed by Medicare.

Ohio Waiver

  • OH Assisted Living
  • OH Home Care Waiver
  • OH Individual Options
  • OH Integrated Care Delivery System (ICDS) Waiver
  • OH Level One Waiver 
  • OH Ohio RISE Waiver
  • OH Self Empowered Life Funding (SELF)

Copayments?

They do not have to pay a copayment. When a member is 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • The hospital (inpatient)
  • A facility for skilled nursing
  • A nursing home

What is not covered by Ohio Medicaid?

In Ohio, Medicaid is not mandated to offer in-home caregiving services or private nursing coverage. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.

What is the highest income limit for Ohio Medicaid?

The highest income limit for Ohio Medicaid is $18,075 for an individual and $24,353 for a family of two per year.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for Ohio Medicaid, thanks to the asset spend down option.  

What documents do I need to apply for Medicaid?

The following documents are required with the application:

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, drivers driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origin 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy (doctors’ certification of the pregnancy and, if applicable, the expected delivery date);
  • When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.

What is the best Medicaid in Ohio?

The top Medicaid health plan in quality and performance is Buckeye Health Plan. 

On its 2018 Managed Care Plans Report Card, released today, the Ohio Department of Medicaid (ODM) gave Buckeye Health Plan the best quality rating of all Ohio managed care plans, with 20 stars across the five categories.

Where do I find the letter showing the reason(s) for denial or discontinuance from Ohio Medicaid?

By signing into your account at Portal, you can see the progress of your Ohio Medicaid application.


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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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