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Medicaid for Youth Aged out of Foster Care

The Ohio Medicaid program includes health care coverage for youth, who aged out of foster care on their 18th birthday, until age 26, regardless of income. Click here to view a flyer about the program.

Frequently Asked Questions

What is Medicaid?

Medicaid is a low cost health coverage program. It provides health coverage benefits to eligible children, pregnant women, families, people who are blind or have disabilities, people who are aged 65 or older, and people who qualify for long term care services.

How can I apply?

There are several ways you can apply for Medicaid. 

  • You can apply on-line by clicking here.
  • You can also apply at your local County Department of Job and Family Services (CDJFS), by mail, or in person, using a paper application.  To find out where your local CDJFS is located, click here.

Who can receive Medicaid through the Youth Aged out of Foster Care Program?

You can receive Medicaid through the Former Foster Care Youth program, if:
  • You are age 26 or younger
  • You were in foster care under the responsibility of the State on your 18th birthday
  • You received Title IV-E foster care maintenance payments or independent living services furnished by a program funded under Title IV-E, before you reached age 18
  • Your PCSA or independent living services worker sends a ODM 01958 form and a Medicaid application to the County Department of Job and Family Services to identify you as a Former Foster Care Youth

What do I need to do to receive Medicaid through the program?

  • Apply for Medicaid
  • Be sure to identify yourself as a former foster care youth
  • Cooperate in establishing eligibility, by providing documents requested by your County Department of Job and Family Services (CDJFS) caseworker 
  • Report changes in address, telephone number, etc. to your CDJFS caseworker within a few days of the change

How will I know if I am eligible?

Your local County Department of Job and Family Services (CDJFS) will process your application and send you a computer generated notice which tells you if you are approved and when your coverage starts.  Be sure to open and read all the mail you receive from your CDJFS.

What does Medicaid cover?

Ohio's Medicaid program provides a comprehensive package of health care services that includes preventive care. Some services are limited by dollar amount, number of visits per year, or the setting in which they can be provided. Some services may require prior authorization by Ohio Medicaid.  To request prior authorization for a service, your medical provider can make a request for prior authorization to ODM for your services.

To learn more about what services are covered by Medicaid, visit the Covered Services page.

How do I get services?

Your initial Medicaid coverage will be through Ohio Medicaid Fee-For-Service.  Under Medicaid Fee-For-Service, you may receive a monthly paper Medicaid card to verify your initial health coverage, so you can access medical services. Your card will contain a 12 digit number, which is your Medicaid billing number.  Your medical providers need this number in order to bill Ohio Medicaid for medicaid services they provide to you.

 

You will be asked to select a managed care plan shortly after being approved for Medicaid.  It's important to check with your doctor before choosing a managed care plan, so you can select a plan from which your doctor accepts payment.

 

Ohio Medicaid has a network of providers statewide, including (but not limited to): hospitals, family practice doctors, pharmacies and durable medical equipment companies. These providers bill Medicaid directly for health care services they provide to Medicaid beneficiaries. Medicaid beneficiaries eligible for getting care through Traditional Medicaid may go to any Ohio Medicaid provider who accepts Medicaid patients. Beneficiaries should ask the provider if they accept Medicaid before scheduling an appointment. For a list of Ohio Medicaid providers, please contact the Consumer Hotline at 1-800-324-8680.

What is Medicaid Managed Care?

You are required to enroll in health care services through a managed care plan (MCP). MCPs are private health insurance companies which are responsible for arranging health care services for its covered members. MCPs provide all of the services offered through Fee-For-Service Medicaid, but additional services may be provided by an MCP. Medical providers, who accept payment from MCPs, bill MCPs directly for health care services obtained by their members. You will receive a health care card and a member services handbook from your MCP once you are enrolled.

Where can I find doctors who accept Ohio Medicaid?

You can search for Ohio Medicaid Fee-For-Service doctors by clicking here.

You can contact your MCP to find doctors who accept payments from your MCP plan. Call the member services telephone number or visit the web site for your MCP plan which is listed on your MCP card.

Be sure to take your health care card and present it at your doctor's office, at each visit, so your doctor knows you have health coverage and can bill the service to the plan.

If you visit a doctor who does not accept your health care coverage, you may be billed for the service and have to pay for it.  Most doctors outside Ohio do not accept Ohio Medicaid.

What if I have questions about my coverage?

For general eligibility questions, you can call the Medicaid Consumer Hotline at 1-800-324-8680.

For questions about covered services for your MCP, call the member services telephone number or visit the web site for your MCP plan listed on your MCP card.

What can I do if my coverage gets denied or terminated?

If your Medicaid application is denied or your Medicaid coverage is terminated, you have several options:

  • You can request a county conference. This is a meeting between you, your caseworker, and the caseworker's supervisor, so you can discuss the case and how to resolve the problem.
  • You can also request a state hearing regarding your benefits denial. This is not a 'hearing' in a court of law.  Instead, a hearings officer, from the Ohio Department of Job and Family Services, will examine the case and determine if the County Department of Job and Family Services (CDJFS) properly or improperly processed the case.  Hearings can order the CDJFS to reprocess eligibility if the CDJFS was in error. 
    • To ask for a hearing, you can call 1-800-635-3748.  You can also fill out the form you received about the denial or termination of your application and mail it to state hearings.  You may also fax the form to 614-728-9574.  You can also request a hearing by emailing BSH@jfs.ohio.gov. You will need to provide the following information in your email request:  Your Name, Your Case Number, Your Address and Telephone Number, and the reason why you are requesting a hearing.
    • Your hearing request must be received within 90 days of the mailing date of the notice of action, in order for ODJFS to conduct a state hearing.  If you request a hearing within 15 days of your Medicaid termination, your Medicaid will continue until the hearing is held.  You can request both a county conference and a state hearing.
  • You can reapply at any time.

Note: Make sure you always report changes in your contact information to your caseworker.  Medicaid mail does not forward; it returns to the CDJFS.  In order to ensure you keep getting Medicaid, always report your new address to your caseworker within a few days of the change.

How can I make a complaint about my caseworker?

If you need to make a complaint about the services of your caseworker, you must do so through your CDJFS and work upward through the local chain of command (i.e., caseworker, supervisor, administrator, assistant director, director, county commissioners' office).

Have questions: Consumer Hotline