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Family Planning Services

The Affordable Care Act - the health insurance reform legislation passed by Congress and signed into law by President Obama on March 23, 2010 - required 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).

What Is and Is Not Covered

What is Covered

  • Birth control and contraceptive devices (including condoms, which can be obtained by presenting your FPS card at the pharmacy) 
  • 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.
    • 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
  • 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 5101:3-9-145101:3-21-025101:3-21-02.35101:1-41-40 and their related appendices of the Ohio Administrative code.

What is Not Covered

  • 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. 
Eligibility Criteria

You may be eligible for the Family Planning Services program if:

  • 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
How to Apply

There are several ways to apply for the Family Planning Services program, you can:

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

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

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.

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?

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.

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

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 BCSP@medicaid.ohio.gov.

Is this FPS card issued monthly?

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.

How long am I covered with this plan?

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:

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

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.

Male and therefore I can't get pregnant; why am I getting this card?

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

A child; why should I receive Family Planning Services?

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.

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