Medical Assistance

MEDICAL ASSISTANCE

Medicaid (medical assistance) is a state and federally funded health care coverage plan providing assistance to certain low-income and medically vulnerable people. The program is designed to promote and safeguard the health of Clinton County residents. 

MEDICAID COVERED SERVICES

Ohio Medicaid programs provides a comprehensive package of services that includes preventive care for consumers. Some services are limited by dollar amount, number of visits per year, or setting in which they can be provided. For more information on covered services you can visit, Ohio Medicaid Covered Services.

WHO IS COVERED BY MEDICAID?

Families and children up to age 19 and pregnant women with limited incomes are covered through Medicaid under Healthy Start or Healthy Families. Additionally, families with children under the age of 18 who participate in TANF (Cash Assistance) are automatically covered. 

Aged, Blind and Disabled. Adults 65 and older can be eligible for Medicaid. Individuals of any age with a disability, including those legally blind, can qualify for Medicaid.  

Individuals with low incomes who are eligible for Medicare can received help with all or part of their Medicare Part B premiums, co-payments and/or other deductibles. 

HOW DO I QUALIFY?

Eligibility for Medicaid is usually determine by income and circumstances. The following individuals may qualify for Medicaid

• Individuals with low-income
• Pregnant women, infants, and children
• Older adults
• Individuals with disabilities including those that are blind
• Children in foster care
• Children who have aged out of foster care until age 21

 To be eligible for coverage, you must:

• Be a United States citizen or meet Medicaid citizenship requirements. 
• Have or get a Social Security number.
• Be an Ohio resident.
• Meet financial requirements

Learn more about the financial requirements of different programs or view examples of financial eligibility by monthly income for children, families and adults or aged, blind or disabled individuals.

There are many ways to apply for Medicaid. You may apply online at Benefits.Ohio.Gov,  calling 1-866-635-3748 (follow the prompts for food assistance) or by filling out the Request for Cash, Food and Medical Assistance form (JFS 7200) and submitting it to your Clinton County Job and Family Services, Family Support Unit. Applications are accepted in-person during normal business hours Monday-Friday 7:30am to 4:30pm. Applications may also be submitted by mail, email or at the drop box located outside of the Job and Family Services Building

MANAGED CARE PLANS

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. Shortly after you enroll on Medicaid, you will get a letter asking you to choose a Medicaid MCO. Visit each plan to learn more and find one that is right for you. If you don’t choose a plan, we will choose one for you. You can change plans up to 90 days from your date of initial enrollment, or during our annual open enrollment period. You may want to consider: what services you might need, which health plan is accepted by the doctors you use, which plan was found to meet the highest quality for your health care needs, and which extra benefits are most beneficial to you.

Once you are enrolled with a MCO, you will get a new card in the mail. MCOs send one permanent card when you enroll. Keep this card for as long as you are on the plan. If you need to replace your managed care ID card, please contact your MCO, or use their online member portal. The plan will also send you information on your doctors, health services and scope of coverage from your plan.

Managed Care works like regular private health insurance. Some services may require prior approval before you can receive them, or there may be limits for the number of services you can receive. Your MCO is available to answer your questions about coverage and help you find providers. You can file a grievance with your MCO, if you are dissatisfied with the MCOs services. You can also request an appeal from your MCO, in the event your pre-services request is denied. Contact your MCO Member Services Department for assistance.

For more detailed explanations of these programs, visit:

• Home | Aetna Better Health of Ohio 833-711-0773
• AmeriHealth Caritas Ohio 833-764-7700
• Anthem Blue Cross Blue Shield 844-912-0938
• Choose Buckeye  866-246-4358
• CareSource 800-488-0134
• Humana Healthy Horizons in Ohio 877-856-5702
• Molina Healthcare of Ohio 800-642-4168
• Ohio UnitedHealthcare Community Plan 800-895-2017