Who is eligible? Most Medicaid beneficiaries are eligible for membership in an Ohio Medicaid managed care plan.
Description: In Ohio, most individuals who have Medicaid must join a managed care plan to receive their health care. Managed care plans are health insurance companies that are licensed by the Ohio Department of Insurance and have a provider agreement with the Ohio Department of Medicaid to provide coordinated health care to Medicaid beneficiaries. These managed care plans work with hospitals, doctors and other health care providers to coordinate care and to provide the health care services that are available with an Ohio Medicaid card. If you have Medicaid, and are in a managed care plan, you need to get most of your health care from health care providers that work with your managed care plan.
MyCare Ohio is a system of managed care plans selected to coordinate physical, behavioral, and long-term care services for individuals over the age of 18 who are eligible for both Medicaid and Medicare. This includes individuals with disabilities, older adults, and individuals who receive behavioral health services. More Information
Long-term services and supports are programs or services that help older adults and people with disabilities accomplish everyday tasks. These tasks may include bathing, getting dressed, fixing meals, and managing a home. As our population ages, the number of individuals needing this kind of help will increase. Long-term services and supports allow individuals to live healthy, secure, and independent lives either in a long-term care facility or in a home and community-based setting.
The Ohio Department of Medicaid offers the following long-term services and supports:
Home and Community-Based Services: Home and community-based services offer individuals with long-term care needs the option of receiving their services at home or in a community setting. These programs serve a variety of populations including individuals with intellectual or developmental disabilities, physical disabilities or mental illness. More Information
Services in a Facility: Individuals who cannot care for themselves at home may require services through a facility-based care setting (such as a nursing home or other long-term care setting). Ohio's Medicaid program can help Medicaid-eligible Ohioans pay for their long-term care. More Information
Additional Services: Additional resources, programs and services are available for individuals who have long-term care needs. These needs may include private duty nursing, hospice services, and targeted case management. More Information
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).
Who is Eligible? Medicaid eligible women between the ages of 40 and 65 diagnosed with breast or cervical cancer, including pre-cancerous conditions.
Description: Provides full Medicaid coverage for certain women diagnosed with breast or cervical cancer or pre-cancerous conditions.
Who is Eligible? Medicaid eligible individuals up to age 21.
Description: Comprehensive preventive health care and support services to Medicaid eligible individuals from birth to 21 years of age.
Who is Eligible? Families with household income up to 90% of the federal poverty level and a child (or children) younger than age 18 in the home with the parent/caretaker.
Description: Provides health care coverage for entire families.
Who is Eligible? Children younger than age 19 and pregnant women who meet specific financial requirements.
Description: Provides health care coverage for children younger than age 19 and pregnant women who qualify based on income.
Who is Eligible? Medicaid eligible children under the age of six should be tested for high blood lead levels.
Description: Pays for lead investigations of the child’s environment to identify cause, and provides treatment for identified high blood lead levels.
Who is Eligible? Pregnant women covered by Ohio Medicaid
Description: Preventive health care and support services that, in addition to regluar prenatal care, can help to increase a woman's well-being during pregnancy an increase the likelihood of a having a healthy baby.
Who is Eligible? Children (younger than age 19), Pregnant Women*, Parent/Caretakers, Adult extension population
Description: Allows children, pregnant women, parent/caretakers and adults in the extension population to be temporarily enrolled in Medicaid while their applications are being processed.
All Medicaid services are covered for children, parent/caretakers, and the adult extension population.
*Only ambulatory prenatal care (for example: doctor visits) and prescription drugs are covered for pregnant women. Hospitalization, and labor and delivery are not covered.
Who is Eligible? Individuals who are age 65 and older, or are legally blind, or are determined disabled by the Social Security Administration.
Description: Provides health care coverage consisting of primary and acute-care benefit packages, along with long-term care, for older adults and people with disabilities.
Who is Eligible? Individuals receiving Medicare.
Description: Provides Medicare recipients with prescription drug coverage.
Who is Eligible? Individuals receiving Medicare and who meet specific income and resource requirements.
Description: Helps people who are eligible for Medicare and have limited income or assets get assistance with paying their Medicare premiums, deductibles, and coinsurance.
Who is Eligible?
Individuals 16-64 years old who are disabled as per the Social Security Administration or as determined by Ohio Medicaid or eligible under the MBIWD medically improved category.
Medicaid Buy-In for Workers with Disabilities (MBIWD) is an Ohio Medicaid program that provides health care coverage to working Ohioans with disabilities.
Who is Eligible? Youth between the ages of 18 and younger than 26 who aged out of foster care on their 18th birthday and received Title IV-E payments.
Description: Provides health care coverage for youth, who aged out of foster care on their 18th birthday, until age 26.
Alien Emergency Medical Assistance
Who is Eligible? Non-U.S. citizens who are not eligible for Medicaid.
Description: Provides coverage for the treatment of emergency medical conditions for certain individuals who do not meet Medicaid citizenship requirements
Refugee Medical Assistance
Who is Eligible? Refugees who have been in the country for less than 8 months, have an income up to 100% of the poverty level, and are ineligible for Medicaid. When applying for RMA, applicants must provide proof of income, pregnancy, citizenship and other health insurance (if applicable).
Who is Eligible? Medicaid eligible pregnant women.
Description: Preventive health care and support services designed to supplement regular obstetrical care available to all Medicaid eligible pregnant women.
Who is Eligible? Pregnant women.
Description: Allows pregnant women to be temporarily enrolled in Medicaid while their applications are being processed.