Disability Determination Redesign

Ohio joined the majority of states in having a single disability determination system on August 1, 2016, simplifying the process for Ohioans to apply for and maintain health care coverage.

Ohio Medicaid has simplified coverage for thousands of Ohioans who previously “spent down” a portion of their income each month to be eligible for health care benefits. In August 2016, the income limit was raised, and individuals with income below the new, higher eligibility limit have been automatically converted to full Medicaid.

  • Individuals no longer need to “spend down” to a more restrictive income limit.
  • Individuals no longer need to apply separately for SSI and Medicaid benefits.
  • Medicaid coverage will be available to more low-income Ohioans.

The disability determination redesign is part of a comprehensive strategy to modernize the administration of Ohio’s Medicaid program. As a result of the disability determination redesign, Ohio will join the majority of states in having a single process for the application and determination of disability benefits

Impact on Individuals

Most individuals who are aged, blind, or disabled and served by the Medicaid program did not have a change in their coverage when these changes took effect on August 1, 2016.

All individuals impacted by the change have a pathway to coverage. Individuals with questions about coverage should contact their local County Department of Job and Family Services to review their individual case.
Additional Resources

Qualified Income Trusts:

Some individuals with income over the state limit may remain eligible for Medicaid by depositing excess income into a Qualified Income Trust (QIT). Free assistance is available to those who need to set up a trust. Contact Automated Health Systems at OhioQIT@automated-health.com or 1-844-265-4722 for more information.

Specialized Recovery Services Program:

Some individuals may be eligible for the new Specialized Recovery Services (SRS) program, allowing them to keep their Medicaid health coverage and receive additional services.