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Medicaid is a publicly-funded health insurance program that provides health coverage to families with low incomes, children, pregnant women, and people who are aged, blind, or who have disabilities.
Below are some frequently asked questions about Medicaid eligibility. The information is believed accurate, but not guaranteed. The State of Ohio disclaims liability for any errors or omissions. Topics covered are:
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Who can be insured by Medicaid? Medicaid provides health care coverage to a number of different groups of people who meet certain financial requirements, including:
- Families - Included in this group are:
- Children up to age 19.
- Pregnant women.
- Families with children under age 18 who participate in the Ohio Works First program (OWF) are automatically insured by Medicaid.
- Families who are not eligible for OWF may still qualify for Medicaid if they meet some of the OWF program requirements.
- Adults, aged 65 or older.
- Individuals with disabilities, including individuals who are legally blind.
- Individuals who are eligible for Medicare can receive help with all or part of their Medicare Part B premiums, co-payments, and/or deductibles.
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How can I qualify?
- You will need to have a Social Security number, or you must apply for a Social Security number.
- You must be a U.S. citizen or a qualified alien to receive Medicaid.
- You must be a resident of Ohio.<
- You must meet certain limits on income and assets.
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How do my assets, such as my home and bank accounts, affect whether I can receive this coverage? Depending on your situation, your assets may or may not be counted. Or, they may only be counted if they are worth more than certain limits.
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If you are applying for Healthy Start, your assets are not counted. If you are applying for coverage because you have a disability, are blind, or are over age 65, or if you are applying for help with your Medicare expenses, some of your assets are counted, such as bank accounts and cash. Many other assets are either not counted, or are counted only if they have value over certain limits. Some examples of assets that are either not counted or counted only partially :
- Your household goods and personal possessions, such as jewelry and televisions, are not counted.
- Your home is not counted if you or your spouse are living in it.
- Certain life insurance policies are not counted or are counted only partially, depending on the kind of policy and its face value.
- Your car may be counted, either totally or partially, depending on how it is used.
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How do you look at my income to see if I qualify for coverage? The way your income is considered depends on your situation. Certain types of income are either not counted or are only partially counted.
When you apply for coverage, you will need proof of your income from any source.
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Can I get Medicaid health care coverage if I already have some
health care coverage? Yes. The fact that you have coverage under another health care insurance plan does not affect your eligibility for Medicaid coverage. It is important, however, for you to provide information about any other health care coverage when you apply for Medicaid so that benefits under both plans can be coordinated. Your medical provider will bill your other coverage, first, and then bill Medicaid for what the other insurance plan did not cover.
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Can I work and still be eligible for this health care coverage? Yes. If you meet the other requirements for this coverage, it does not matter if your income comes from your job or from some other source.
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Is there a limit on how much income I can have? The income limits vary depending on your situation and the program you are applying for. If your monthly income is at or below the limit for that program, you may qualify.
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I was told my income is too high for regular coverage, but that I might qualify for Spenddown Medicaid. What does this mean? If you are aged, blind, or have disabilities and your income is too high, you may still be able to qualify. When you apply for coverage, the county Department of Job and Family Services will evaluate this for you.
Under this type of Medicaid coverage, you can receive coverage in any month that your medical costs are as much as or more than the amount by which your income exceeds the income limit. Medical costs such as doctor visits, prescriptions, past medical bills, and medical insurance charges can be used to meet the spenddown amount.
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I am covered by Medicare. Can you help me with my monthly premiums and other costs? Depending on how much income you have, there are several types of help available through Medicaid with your Medicare premiums and related costs.
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My relative is moving into a nursing home. Can he/she receive help with these costs? Yes. Medicaid does provide coverage to qualifying people who live in or are moving into nursing homes. There is also some assistance available that can help qualified people continue to live in the community if they need the type of medical services normally provided by a medical institution.
If a person needing nursing home services has a spouse or children, it is possible that some of that person's income and assets can be kept to support the family members who remain at home.
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How can I apply for Medicaid in Ohio? To apply for Healthy Start coverage, call the Ohio Consumer Hotline at 1-800-324-8680. The hotline can help you fill out a simple two page application and let you know what other documents you will need. The Hotline can also tell you how to apply for the other kinds of health insurance coverage described above.
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Where can I get more information? If you have questions, or would like more information about the health care coverage described here, you can call the Ohio Consumer Hotline at 1-800-324-8680. People with hearing problems can call the TDD 1-800-292-3572. The Hotline is staffed from 8:00 a.m. to 8:00 p.m. on weekdays, and from noon to 5:00 p.m. on weekends. Your can also call your local county Department of Job and Family Services weekdays during regular business hours.
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