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Who qualifies for Medicaid?

On Behalf of | Sep 30, 2019 | Medicaid And Medicare |

Federal and state Medicaid programs work together to provide health care to more than 72.5 million Americans who have limited resources. To receive Medicaid coverage, individuals must meet both financial and nonfinancial criteria.

If you or a loved one has health problems and struggles to afford care, learn more about Ohio Medicaid eligibility.

Eligibility requirements

Medicaid is available for infants, children, pregnant women, individuals who have a disability and/or are blind, adults older than age 64 and those who have a household income under the established state threshold. You must also be a state resident and have a valid Social Security number, and have proof that you are either a U.S. citizen or legal immigrant.

Income guidelines

Financial eligibility for Medicaid depends on the size of your household. If you live alone, you must earn less than $16,612 per year to qualify for Medicaid. Two-person households can earn up to $22,491, and the threshold currently increases by $5,878 with each additional household member.

Applying for Medicaid

Ohio maintains an online system where you can apply for Medicaid, check your eligibility and manage existing benefits. Once you complete the initial application, a representative will review your case and request more information if necessary. If you receive Medicaid approval, the state will automatically enroll you in fee-for-service coverage and ask you to choose a managed care plan. You will have access to care from a statewide network of providers who accept Medicaid and will be able to choose the doctors you see within that network.

If you do not receive Medicaid approval, you have the right to appeal your case. You can also hire a lawyer to represent you during the appeal process.

The state reviews eligibility for Medicaid every 12 months. If you have a change in circumstances that affects your eligibility, you must notify your case worker within 10 business days.

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