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Ohio's Medicaid Rules and Regulations

Medicaid is a state-operated, federally- and state-funded health insurance program for specific low-income populations. Every state's Medicaid program provides coverage to low-income disabled and elderly individuals, pregnant women and children; some states also extend coverage to certain immigrants, individuals with HIV or AIDS, women with breast or cervical cancer and other special groups. Ohio's Medicaid program provides coverage for low-income children, pregnant women, families, elderly or disabled individuals and certain women with breast or cervical cancer. Apply for Ohio Medicaid through the local Department of Job and Family Services office.

  1. Citizenship and Residency

    • You must be a U.S. citizen or qualifying alien and a resident of the state of Ohio to be eligible for Ohio's Medicaid program.

    Income Limits

    • As of 2009, the income limit for Medicaid Buy-In for workers with disabilities (MBIWD) was $2,257 per month, the income limit for the elderly--age 65 and over and disabled--was $589 per month for individuals and $1,011 for couples. Income was $1,805 per month for pregnant women and if the household includes a child under age 19, the income limit is $2,429 for a household size of two, $3,052 for a household size of three and $3,675 for a household size of four.

    Resource Limits

    • As of 2009, if an individual is elderly or disabled, the monthly income limit was $1,500 if single and $2,250 if a couple. The resource limit for MBIWD is $10,580.

    Extra Help for Dual Eligibles

    • Dual eligibles are individuals who receive both Medicaid and Medicare Part A and B benefits. If you receive both, you may qualify for Qualified Medicare Beneficiary (QMB) benefits. QMB pays a Medicare Part B premium, co-insurance, co-payments and deductibles and covers any out-of-pocket expenses associated with Part A. As of 2009, the monthly income limit to qualify for QMB for an individual was $867 and $1,167 for a couple.

    Covered Services

    • Medicaid covers numerous services, including mental health services, family planning services and supplies, most prescription medications, as well as emergency and non-emergency medical transportation. Medicaid also covers nursing home care, inpatient hospitalization, home health care, surgeries and office visits with a primary care physician or specialist and more. Dental coverage is very limited for individuals age 21 and over: root canals are not covered and a maximum of $600 of dental work, which includes one annual dental check-up, cleaning, fillings and extractions, may be covered per calendar year. Eye glasses and eye exams are only covered once every two years.

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