Family Planning Services (FPS)

The Affordable Care Act - the health insurance reform legislation passed by Congress and signed into law by President Obama on March 23, 2010 - helps make prevention affordable and accessible for all Americans by requiring health plans to cover recommended preventive services without cost sharing. Learn more about the Affordable Care Act by clicking here.

FPS is a limited-benefit Medicaid program that provides services for the prevention of or delay of pregnancy and for the diagnosis and treatment of sexually transmitted infections (STIs).  FPS is a category of medical assistance which may be available to both men and women who apply for Ohio Medicaid.

Reproductive and sexual health care services can help prevent unintended pregnancy, HIV, and other STIs.Supporting access to affordable contraceptive services can reduce unintended pregnancy. Health services can also help promote knowledge about, and compliance with, recommended screening and vaccination for specific STIs.

Healthy reproductive and sexual practices can play a critical role in enabling people to remain healthy and actively contribute to their community. Planning and having a healthy pregnancy is vital to the health of women, infants, and families and is especially important in preventing teen pregnancy and childbearing, which will help raise educational  attainment, increase employment opportunities, and enhance financial stability. Access to quality health services and support for safe practices can improve physical  and emotional well-being and reduce teen and unintended pregnancies, HIV/AIDS, viral hepatitis, and other sexually transmitted infections (STIs).

 Services covered under Family Planning include, but are not limited to:

- Birth control and contraceptive devices (including condoms) 
- Sexually transmitted infections (STIs) tests and treatment (except HIV and Hepatitis B)
- Screenings for cervical cancer and/or Mammograms (when indicated by a breast examination during a routine or periodic family planning visit)

- Immunization vaccines for children from birth to age 18 -doses, recommended ages, and recommended populations vary: Hepatitis A, Hepatitis B, and Human Papillomavirus are covered immunization services for children who receive medical assistance through FPS.

- FPS also offers prevention counseling and screening for adolescents and adults for STIs.  

- Some procedures and services may require your provider to request prior authorization of coverage.

More detailed information regarding services, supplies, and medications covered by FPS are available in sections 5101:3-9-14, 5101:3-21-02, 5101:3-21-02.3, 5101:1-41-40 and their related appendices of the Ohio Administrative code. 

You may be eligible for FPS if you:

- Are a U.S. citizen or a qualified alien
- Are a resident of Ohio
- Are a man or woman of any age
- Have countable family income which does not exceed 200% of the Federal Poverty Level for your family size plus one
- Are not eligible for other Medicaid programs, including delayed spenddown
- Do not have other health insurance

Apply for FPS:

- Submit an online application here or

- Fill out an application through your local Ohio Benefit Bank site.  To find a site nearest you, visit: www.ohiobenefits.org

or

- Submit a paper Medicaid application to your local county department of job and family services (CDJFS) by mail, fax, email, or in person. You can use any of the following applications: JFS 07200, JFS 07216, JFS 07103,JFS 07161or JFS 01137/01138. Medicaid does not have an incorrect application.  You can use any of these five forms under section 5101:1-38-01.2 of the Ohio Administrative code. You can find the address and phone number of your county agency at http://jfs.ohio.gov/County/County_Directory.pdf,

or

- Call the Medicaid Consumer Hotline at 1-800-324-8680 for assistance.

If you are eligible for FPS:

- You will receive a monthly Medicaid card
- You will have 12 months of coverage before you have to reapply
- Only Family Planning Services will be covered
- You may ask your CDJFS for necessary Non-Emergency Transportation (NET) assistance for travel to and from providers who provide services covered under the FPS program. You cannot receive NET services for any services not covered by FPS. 

 Frequently Asked Questions:

Q1.  I received a Family Planning Services (FPS) card, do I have Medicaid?

A1.  If you receive an FPS card, you have limited coverage medical assistance through the Ohio Medicaid program. The services are limited to those listed above and in the cited sections of the Ohio Administrative Code. 

Q2.  I did not sign up for this, why did I receive this benefit?  Can I get back on regular Medicaid?  If I don't want to receive this card, can I opt out?

A2.  There are a numerous medical assistance programs offered through the Ohio Medicaid program. If you are approved for FPS, it means you did not qualify for any other programs, but were found to be income eligible for FPS. If you do not wish to receive an FPS card,  tell your case worker, and he/she can terminate the FPS coverage.

Q3. Why didn't someone tell me my coverage was changing?

A3. You should have received written notices in the mail informing you that your coverage was changing.  You have the right to appeal the change within 90 days of the change by requesting a state hearing.  If you want to request a state hearing, you can call 866-635-3748, send a facsimile request to (614)728-9574 or email BSH@jfs.ohio.gov.

Q4.  Is this FPS card issued monthly?

A4.  Yes, the FPS card is issued monthly.  It is called a 'Fee for Service' card.  Each month you are eligible,  you will receive the card in the mail.

Q5. How long am I covered with this plan?

A5. FPS certification periods are 12 months in length. You will be eligible to receive FPS as long as your countable income does not exceed 200% of the Federal Poverty Level.  In 12 months, your case worker will review your eligibility to see if you will still qualify for FPS coverage.

 I don't think I can benefit from this card, I am:

1. past menopause or have under gone sterilization surgery and can't have children, why should I have Family Planning Services? 

A1.  Individuals, who are post menopausal or previously had sterilization surgery, will not benefit from the FPS program as visits for STI treatment and diagnosis, mammograms, etc. must be associated with a reproductive visit relative to the prevention of or delay of pregnancy.

2. male and therefore I can't get pregnant; why am I getting this card?

A-2.  Males can receive contraceptive devices (condoms), sterilization, and diagnosis and treatment for possible STI's through the FPS program.

3. a child; why should I receive Family Planning Services?

A-3. A child or adolescent can receive immunizations against HPV, Hepatitis A and Hepatitis B, if an immunization is associated with a reproductive visit related to the prevention of or delay of pregnancy. 

 

Types of service are covered under FPS (not an all-includsive list):

Mammograms:  You can receive a referral for a mammogram from a medical provider
during a routine examination for breast cancer or family planning visit, as long as the visit was for the prevention of or delay of pregnancy.

Condoms:  You can obtain condoms with your FPS card by presenting your card at the pharmacy.

Other birth control methods- pills, IUD, shots, etc:  There are many types of covered
birth control types.  For more information, visit the provider rules listed above in
the covered services section.

HPV immunization (Gardasil®) for individuals aged 9-26 years to assist in the prevention
of certain types of cancers and/or genital warts caused by HPV, if the immunization is associated with a reproductive visit related to the prevention of or delay of pregnancy.

Treatment of a yeast infection: FPS may cover treatment of a yeast infection which was
diagnosed as an STI by a medical provider during a family planning visit for the prevention of or delay of pregnancy.

 These services are not covered under FPS:

Services and treatments are not provided for Hepatitis C

Services and treatment are not provided for HIV

Dental or vision services

Diagnosis or treatment of infertility

Reversal procedures after a tubal ligation or vasectomy, or any other sterilization procedure

Pregnancy planning (getting pregnant): FPS is a pregnancy prevention program, not a program meant to assist in causing or creating a pregnancy.