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1. What is Medicaid?

Medicaid is a public health care program funded by the state and federal government. It provides necessary health care coverage to certain individuals with limited income. In Ohio, a person is entitled to Medicaid health care coverage for free or at a low cost if they meet specific income and eligibility requirements. As an entitlement program, the state cannot limit the number of eligible persons enrolled in Medicaid or deny access to medically necessary services to control costs.

2. Who is covered by Medicaid?

Ohio Medicaid provides health care coverage to children, pregnant women, families, adults age 65 and older and people with disabilities. Some consumers may need to pay monthly premiums or copays for certain services. Learn more about the covered groups.

3. How do consumers receive Medicaid services?

Once enrolled, consumers can get health care services from a Medicaid provider who accepts Medicaid as health insurance. This is generally called fee-for-service Medicaid. Consumers may be required to get their services from a Medicaid managed care plan. Both fee-for-service Medicaid and the managed care plans provide all medically necessary primary, specialty and emergency care, and preventive services.

Ohio Medicaid also provides both home health care and facility-based services for those consumers requiring long-term care services. Home care services allow consumers to remain in their homes and communities. Long-term care services are also available for consumers needing care in nursing homes and facilities for persons with mental retardation. Alternatives to institutional care are offered through home and community-based services waivers (e.g., PASSPORT, Ohio Home Care).

4. What services does Medicaid cover?

Ohio’s Medicaid Program includes services mandated by the federal government as well as optional services Ohio has elected to provide. Some services are limited by dollar amount, the number of visits per year, or the setting in which they can be provided. With some exceptions, all medically necessary services are available to all Medicaid consumers. View details on Federally Mandated and Ohio’s Optional Services.

5. What are the monthly income guidelines?

For details on monthly income guidelines, view a table outlining this information.