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Ohio Medicaid
State
Ohio Medicaid is a health insurance program paid for by the federal and state governments. It helps lower health care costs for people of all ages. You may be able to get help from Medicaid if you have limited income and resources. Learn more about how this program can help or see if you qualify for Ohio Medicaid today.
About this program
Medicaid is a government health insurance program that helps people with limited income pay for health care. Ohio offers different Medicaid programs to meet the needs of different groups of people, including older adults, people with disabilities, and families.
What does Ohio Medicaid cover?
Ohio Medicaid pays for routine and acute health care services. This includes:
- Visits to health care providers (including physicians and nurse practitioners)
- Inpatient and outpatient hospital services
- Early and periodic screening, diagnostic, and treatment services
- Preventive care (e.g., vaccinations)
- Lab tests and X-rays
- Dialysis services
- Mental health services
- Substance use treatment
- Rural health clinic services
- Medical transportation
- Long-term care (e.g., nursing facility care, home health services)
Most states also cover optional services such as:
- Physical, respiratory, and occupational therapy
- Home- and community-based care
- Case management
- Prescription drugs
- Dental and vision care
- Hearing services
- Podiatry services
- Hospice care
Since the program serves those with limited income and resources, people with Ohio Medicaid pay few to no out-of-pocket costs for their benefits. To get coverage once you are enrolled, you must go to health care providers that take part in the Ohio Medicaid program.
In Ohio, Medicaid is run by the Ohio State Department of Health. Call the Medicaid Consumer Hotline at 1-800-324-8680 to learn more about the coverages provided.
How do I know if I qualify for Medicaid in Ohio?
In general, to be eligible for Medicaid, you must:
- Be a Ohio resident
- Be a U.S. citizen or a qualified non-citizen
- Meet the income and/or asset limit for your coverage group
What are the different Medicaid programs in Ohio?
You may be able to get health coverage from one of the programs below.
Nursing Home Medicaid
Ohio Nursing Home Medicaid helps pay for long-term care in a nursing home if you meet the program's medical and financial rules. If you qualify, Medicaid may cover your room and board, nursing care, rehabilitation, prescription drugs, medical supplies, and other health care services you need while living in the nursing home.
PASSPORT Medicaid Waiver Program
The Ohio PASSPORT Medicaid Waiver Program helps older adults who need long-term care stay in their own homes instead of moving to a nursing home. If you qualify for Medicaid and need a nursing home level of care, the program may pay for services such as personal care, homemaker services, home-delivered meals, transportation, adult day services, and home modifications to help you live safely at home.
Medicaid Buy-In for Workers with Disabilities (MBIWD)
In some situations, working and earning money could prevent you from getting public benefit programs such as Medicaid. If you live in Ohio, have a disability, and are a paid worker (part-time or full-time), MBIWD may be able to provide you with health care benefits. For Ohioans, MBIWD lets you work, keep money in savings, and still keep your health care coverage. You may have to pay a monthly premium if you have an annual gross (total) income greater than 150% of the federal poverty level (FPL). Some resources may not be counted when deciding eligibility.
You are eligible for MBIWD if you meet the income limits and you are:
- A U.S. citizen or meet U.S. citizen requirements
- A resident of Ohio
- Between 16 to 64 years old
- Living with a disability as defined by the Social Security Administration (SSA)
- Employed in paid full or part time work
You can use the regular Medicaid application process to apply for Ohio MBIWD. Be sure to say you are applying for MBIWD, not regular Medicaid. You will also need to provide proof of your disability and your job or income.
How do Medicare and Medicaid work together?
If you get Medicare, you may also be able to get help from Ohio Medicaid. This is called being “dual eligible.” Medicaid pays for some services not covered by Medicare such as eyeglasses, hearing aids, and dental care.
If you have Medicare and qualify for full Medicaid coverage, the state will pay your Medicare Part B (Medical Insurance) monthly premiums.
Depending on the level of Ohio Medicaid you qualify for, the state might also pay for:
- Your share of Medicare costs, like deductibles, coinsurance, and copayments
- Part A (Hospital Insurance) premiums, if you have to pay a premium for that coverage
In addition, if you are dual-eligible for Medicare and Medicaid:
- You will automatically be signed up for the Low-Income Subsidy (LIS)/Extra Help program through Medicare Part D (prescription drug coverage). This program helps people with low income pay for their medicines.
- You may be able to get your coverage through a Medicare Advantage Special Needs Plan (SNP) instead of having original Medicare with separate Medicaid coverage. This plan can help you manage the health care services you need. SNPs may also offer more benefits than what you already get from original Medicare. In some cases, you may have no monthly premiums and/or you may pay lower co-payments. All SNP plans are different, so check with the plans to see what they cover and if you can enroll.
Note: SNPs are not available in every community. To find out if there is an SNP in your area, call 1-800-MEDICARE (1-800-633-4227; TTY: 1-877-486-2048) or call the Ohio Senior Health Insurance Information Program (OSHIIP) at 1-800-686-1578.
How do I prepare to apply for Medicaid in Ohio?
When you apply for Medicaid in Ohio, you’ll be asked for important information to help determine if you qualify for benefits.
Before you start, gather some basic information to make things easier:
- A document that shows your age, such as your birth certificate or driver’s license
- Your Social Security card
- Pay stubs for anyone in your household who has earned income
- Documentation that shows any other form of income, such as letters from Veterans Affairs (VA) or the Social Security Administration (SSA)
- Information about your financial assets, such as bank account or investment account statements
How do I apply for Medicaid in Ohio?
The quickest and easiest way to apply for Medicaid in Ohio is online through the Ohio Benefits self-service portal. All your personal information is kept 100% confidential and protected by special security technology.
When you arrive on the site, click “Apply for Assistance." You will have to create an account first if you don't have one. To register, click "Create Account." If you already have an account, you can login to start your Medicaid application or pick up where you left off.
Apply by Phone
Call the Medicaid Consumer Hotline at 1-800-324-8680, where they will help you complete an application and answer questions. For TTY, please dial 1-800-292-3572.
Apply in Person
If you want to apply for Medicaid in person, you can visit your local Ohio Department of Job and Family Services office. Find yours here.
How can I get help with my Ohio Medicaid application?
- Call the Medicaid Consumer Hotline at 1-800-324-8680.
- Visit your local county office.
- Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s one in your area.
NCOA also has a HelpLine you can call to get free support. Call [1-800-794-6559](tel:+18007946559) anytime Monday–Friday, from 8 a.m. to 7 p.m. EST.
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Informational only — official eligibility is determined by the administering agency.
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