Medicaid and Medicare Insurance in Ohio

Ohio State residents who are in need of health care can apply for Medicaid in a number of ways. Applicants can apply for Medicaid at any point in the year. There’s no deadline to apply for Medicaid because a person’s health status may change overnight. As long as the applicant meets the state of Ohio’s eligibility requirements for Medicaid, they will be provided with coverage.

People who are interested in completing Medicaid application forms are encouraged to check their eligibility and discover where to apply for Medicaid before proceeding to the next step. This way, an applicant can avoid wasting their time filling out the Ohio Medicaid application if she or he is not eligible for coverage in the first place.

How to Apply for Medicaid in Ohio Online

Applicants can apply for Medicaid online through the state’s Medicaid website, known as “Ohio Benefits.” Access the self-service portal section of the Ohio Benefits website to begin the Ohio Medicaid application process. Ohio Benefits requires each applicant to create a unique username, as well as a password. Ohio Medicaid applications are not strictly limited to the Ohio Benefits website. You can also apply through the Federal government’s health care website online for Medicaid in Ohio. Reach out to the Federal government if you opt to apply for Medicaid through the Federal government’s health care website and have questions about the application.

Be sure to include your gross monthly income, rather than your net monthly income, when completing your Ohio Medicaid application on the World Wide Web.

In the event you have no income whatsoever, do not enter zero dollars ($0). The self-service portal will expedite the processing of your Ohio Medicaid application in the event you put in one dollar ($1) instead of zero dollars, should you currently be unemployed. Failing to provide it will slow the processing of your application process though you are not required to provide your Social Security number on the Medicaid application. In case you lack a Social Security number or don’t remember your Social Security number, do not put a fake number or all zeroes when you apply for Medicaid, as doing so will delay the processing of your Medicaid application.

Medicare Insurance OhioGeneral Program Requirements

Medicaid programs must follow federal guidelines. However, they vary somewhat from state to state.

Generally, for this benefit program, you must have low income and must be a permanent resident or a US national, citizen, or legal alien.

You must also be a resident of the state of Ohio.

Who Qualifies for Coverage?

The following individuals may qualify for Medicaid coverage in Ohio:

  • Individuals with low-income
  • Pregnant women, infants, and children
  • Older adults
  • Individuals with disabilities

To be eligible for coverage, you must:

  • Be a United States citizen or meet Medicaid citizenship requirements. Your local county Job and Family Services office can help to explain these requirements and can help get you enrolled.
  • Have or get a Social Security number.
  • Be an Ohio resident.
  • Meet financial requirements. You still ought to apply, even if you are not sure that you or your family will qualify for coverage.

Medicaid State Plan

The State Plan is a comprehensive written statement that assures it is administered in conformity with federal requirements and regulations and describes the nature and scope of the Ohio Medicaid program. The information provided on this particular page is for informational purposes only, and ODM disclaims any obligation or liability based upon its use.

Alternative Benefit Plan (ABP)

The Affordable Care Act (ACA) mandated that expansion states, such as Ohio, must have an ABP for the adult expansion population, also known as Group VIII (because it is defined in Section 1902(a)(10)(A)(i)(VIII) of the Social Security Act). Although with just a number of exceptions, the benefits in the ABP mirror the traditional Medicaid state plan in Ohio to assure mental health equality mandated by the ACA. The ABP is a separate state plan from the traditional Medicaid state plan.

Medicaid Expansion in Ohio

Kasich announced in early 2013 that the state would expand Medicaid using federal money to pay for the vast majority of the cost (the federal government paid the full cost throughout 2016, and under the current rules the federal government will always pay at least 90 percent of the cost of covering the newly eligible population.

Ohio lawmakers who were opposed to Medicaid expansion brought a lawsuit against the Kasich administration in an effort to block expansion since the full legislature was not involved in the decision to expand Medicaid – it was done through the Controlling Board (six legislators who handle budget adjustments in the state – most states don’t have something like this) after the Ohio House and Senate both voted to block Medicaid expansion and Kasich vetoed their measure.

Ultimately, in late 2013, the Ohio Supreme Court ruled in favor of Governor Kasich, and as scheduled in 2014, the Medicaid expansion took effect. During the 2015 legislative session, lawmakers agreed to allow Medicaid expansion to continue, although the issue was just part of the budget agreement – there was no separate legislation on Medicaid expansion.

CMS Denies Request to Make Expansion More Conservative

In September 2016, CMS denied a new waiver proposal from Ohio that would have required all enrollees (including those with income below the poverty line) to pay 2 percent of their income (but no more than $99 per year) into a health savings account. The problem for CMS was that the new guidelines would have resulted in people losing their Medicaid coverage if they are more than 60 days behind their health savings account payments, and they would have had to get caught up on the payments to be able to re-enroll in the coverage.

The state noted an estimate of 125,000 people would lose coverage under the new guidelines, which was a non-starter for CMS – particularly as the state wanted to bar people from re-enrolling until they paid their overdue contributions. The feds have approved some states’ Medicaid waivers that require premiums or health savings account payments for people with income above the poverty level but has not yet approved any states’ requests to condition continued eligibility for people below the poverty level upon payments to a health savings account.

Buckeye Health Plan

Should you qualify for both Medicare and Medicaid, the State of Ohio offers a Dual Eligible Special Needs Plan (DSNP). This plan includes all the benefits of Medicare Part A (hospital insurance) and Medicare Part B (medical/outpatient insurance) PLUS other important benefits that help you take care of yourself, with extras like vision care and prescription drug coverage. This Medicare Advantage plan works with your existing Medicaid coverage to give you even more benefits.

Buckeye Health Plan is contracted with Medicare for an HMO SNP plan, and with the Ohio Medicaid program. Enrollment in Buckeye Health Plan depends on contract renewal. This plan is available to anyone who has both Medical Assistance from the State and Medicare.

See More: Work-Related Social Security Disability