Medicaid Eligibility – State of Ohio


Funded by both the federal and state government, the health insurance program known as Medicaid was designed with low-income families in mind. Children, elderly, and disabled members of society are often first among the list of eligible applicants in the state of Ohio.  Before applying, it is important to note the state’s specific criteria for getting approved and accepted into the program to receive coverage.

Ohio’s Requirements for Medicaid Qualification

Ohio only approves applicants who meet the necessary requirements as set  forth by the state. Certain income standards ensure only those who truly need the assistance receive it. With thousands of people on Medicaid in the state, it is not possible for everyone to get approved. Children and pregnant women are among the most common recipients, although adults who fall below the poverty level are now eligible as well. The Ohio Benefits website allows potential applicants to check if they may be eligible for services before even having to submit a full application.

How to Apply for Medicaid in in Ohio

Multiple methods exist for applying for Ohio Medicaid. Many people have taken to the online version which is fast to use and initiates a quick response.  A pop-up window comes on the screen when attempting to start a new application. It allows users to either sign in with an existing account or create an account if it is their first time. Provide a first and last name, date of birth, and social security number to sign up and start the process.

Those who do not wish to use the online version may instead visit their local office to fill out a paper form. It can get submitted directly to a worker who can assess the information and approve or deny the claim. It is also possible to apply by telephone by calling the Ohio Medicaid Consumer Hotline at (800) 324-8680.

Ohio Medicaid Application

Start by creating an account that allows you to access your information now and in the future. First and last name, date of birth, and social security are required to create the account and begin the process. After setup, the application will allow you to fill out questions and provide the necessary details. Contact details, income information, outgoing bills, bank account information, and more needs to get disclosed so your caseworker can determine your eligibility and need.

What Does Medicaid Cover in Ohio?

A variety of covered services provide Medicaid recipients with the medical care they need. Emergency room visits, dental care for those under 21, family planning services, inpatient and outpatient hospital services, pregnancy, preventative health, and more ensures all Medicaid patients get the care they require when they require it.

Income Requirements for Ohio Medicaid

Household size and total amount of income versus outgoing bills plays a part in determining the income limit for each family. Single-family households can make up to $15,800 per year, while a four-person family can bring in $32,319 per year to qualify. Those who fall well below the poverty line, as well as children and pregnant women, qualify most often.

How Much Does Medicaid Cost in Ohio?

More than $21 billion gets spent on Ohio Medicaid costs.  The federal government shares these expenses with the state, with Ohio  allocating over 37 percent of their budget to its funding. This amount will only grow over time, as there are plans to expand the program to  ensure more people who need coverage can receive it.

Cost and Coverage of Medicaid in Ohio

Low-income families do not usually have the means to pay for services. The state and federal program offered covers all or nearly all of the costs instead. There may be a co-pay for some recipients, but it is often a small dollar amount that is doable for most people. Non-emergency services and dental services typically only have a $3 co-pay associated with them.

Prescription Drugs with Medicaid in Ohio?

Some prescription drugs are covered by Ohio Medicaid. Some come fully covered, while others have a co-pay involved to purchase them. Generic medicines cost less, often just $2 per bottle. Medications that require a prior authorization from a doctor to obtain cost at least $3 to fill.

Which Medicaid Plan is Best in Ohio?

Five Medicaid plans exist in Ohio. While each has its ideal qualities, one of the best plan choices is CareSource. It receives high ratings for keeping kids healthy and the communication and service provided by associated doctors

The following individuals may qualify for Medicaid coverage in Ohio:

  • Individuals with low-income
  • Pregnant women, infants, and children
  • Older adults
  • Individuals with disabilities

To be eligible for coverage, you must:

Non-U.S. citizens may be eligible for Alien Emergency Medical Assistance or Refugee Medical Assistance