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.
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.
There are several ways you can apply for Medicaid.
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.
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.
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.
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.
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.
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.
If your Medicaid application is denied or your Medicaid coverage is terminated, you have several options:
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.
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).