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Medical Assistance

Overview

Medicaid (medical assistance) provides health care coverage to families who may not otherwise have access to health care. The program is designed to safeguard the health and well-being of Allen County residents, particularly children, pregnant women, elderly, individuals with disabilities, and those looking for Long-Term Care and/or In-Home Waiver Care.

Medicaid programs include Healthy Start; Healthy Families; Healthchek; Pregnancy-related services; and Aged, Blind and Disabled among others. Individuals who receive Medicare, but whose income is too high to qualify for Medicaid, may be eligible for the Medicare Premium Assistance Program.

Do I Qualify?

Allen County Job and Family Services administers several different types of Medicaid, but eligibility is usually based on income and circumstances.

Allen County Job and Family Services oversees Medicaid programs that provide health care coverage to:

• Income-eligible parents and their children up to age 21
• Preventive and treatment services up to age 21
• Pregnant women
• Older adults, ages 60 and older
• Income-eligible people with disabilities
• Children in foster care
• Children who have aged out of foster care up to age 21
• Adults ranging in ages 19-64, depending upon eligibility factors

Resources

Apply For Medicaid Only

In some cases, you may want to apply to receive Medicaid without applying for cash or food
assistance. By visiting www.benefits.ohio.gov or calling 1-844-640-OHIO (6446), you can apply for
Medicaid only, without applying for cash or food assistance at the same time.
To apply through the site, click “Check your eligibility” and follow the prompts.

Visit benefits.ohio.gov

Managed Care Plans

In Ohio, most individuals who have Medicaid must join a managed care plan to receive their health care. Managed care plans are health insurance companies that are licensed by the Ohio Department of Insurance and have a provider agreement with the Ohio Department of Medicaid to provide coordinated health care to Medicaid beneficiaries. These managed care plans work with hospitals, doctors and other health care providers to coordinate care and to provide the health care services that are available with an Ohio Medicaid card.

Once you are approved for Medicaid, you will receive information in the mail to help you select a managed care plan. You will have the opportunity to change managed care plans during open enrollment each November.

For more detailed explanations of these programs, call or visit:


Managed Care plans act just like regular health insurance. Once you are enrolled in a managed care plan, you should receive a new card in the mail. You will only receive one (1) card. If you need a duplicate, or if your card is lost, please contact your HMO/Medicaid using the above available numbers.  For more information on Ohio Medicaid Managed Care, CLICK HERE

Medicare Premium Assistance

Medicare is different from Medicaid. Medicare is the federal health insurance program for persons age 65 and older, and to some persons of all ages who have a disability. The Medicare Premium Assistance Program (MPAP) is a program for Medicare consumers whose income is too high to qualify for Medicaid. This program helps people eligible for Medicare who have limited income and assets get help in paying the cost of one or more of the following:

  • Medicare premium(s)
  • Medicare deductibles
  • Medicare coinsurance

No face-to-face interview is needed to apply for the Medicare Premium Assistance Program. Consumers may call 1-800-324-8680 for an application or apply through Allen County Job and Family Services.

TO QUALIFY FOR THE MEDICARE PREMIUM ASSISTANCE PROGRAM, APPLICANTS MUST:

  • Be eligible for Medicare;
  • Be a U.S. citizen or meet Medicaid citizenship requirements;
  • Be an Ohio resident;
  • Have or get a social security number; and
  • Meet certain financial requirements

When applying for MPAP, proof of income, resources, age or disability, citizenship (if not a U.S. citizen) and other health insurance is required. No face-to-face interview with the local county department of job and family services is necessary. Applicants can ask an authorized representative to apply on their behalf.

FEDERAL MEDICARE INFORMATION

ACJFS MPAP BROCHURE

Medicaid Expansion

Ohio is now accepting applications for Medicaid under the expanded guidelines implemented under the Affordable Care Act.

Medicaid Expansion expands Medicaid eligibility to 138% of the Federal Poverty Level and includes adults without children (under age 65). Gross monthly income is used to determine eligibility. See the chart below to determine if you might qualify for Medicaid under expansion based on your household size and income.

 

SUBMIT YOUR APPLICATION ONLINE

The quickest and easiest way to apply for health care benefits is online at www.benefits.ohio.gov.  There you will answer a series of questions and your answers will direct you to the correct application for health care.

  • If your income is within the new legal limit implemented by Medicaid Expansion (for eligibility effective Jan. 1, 2014), you will be directed to the citizen’s self-service portal.
  • If you are over income, you will be directed to the Federally Facilitated Health Insurance Marketplace to shop for health care.

After you submit your application online, you may be asked to send verification documents to Allen County Job and Family Services. The best way to return documents is to fax them to (419) 227-2448.

Visit www.healthcare.gov or www.benefits.ohio.gov to learn more or call the Medicaid Consumer Hotline at 1-800-324-8680. Representatives are available to answer questions related to eligibility for Medicaid due to the Affordable Care Act and Medicaid Expansion and answer questions about where to apply.

 

SUBMIT A PRINT APPLICATION

If you are unable to complete an application online, print a Medicaid-only application, or you can complete an application in person at our office.

The best way to return a print application is to fax it to (419) 227-2448.  You can also return applications via mail to 951 Commerce Pkwy., Lima, OH 45804-4506, or deliver them in person to the same location.

Program Enrollment and Benefit Information

For complete information about cash, food and medical assistance, you may want to review the Ohio Department of Job and Family Services (ODJFS) Program Enrollment and Benefit Information booklet.

The booklet may help you determine:

  • What types of services ODJFS offers
  • Frequently asked questions about applying
  • The difference between various Medicaid programs and services
  • Your rights and responsibilities
  • Information about state hearings
  • Penalties for providing false information or committing fraud
  • How we use social security numbers
  • Information about citizenship and immigration status
  • Your civil rights
  • And other helpful resources

LEARN MORE

Non-Emergency Medicaid Transportation

Non-Emergency Transportation (NET)

Non-Emergency Transportation (NET) is a statewide program administered by Allen County Job and Family Services for Medicaid eligible customers. NET provides transportation to and from Medicaid providers. Transportation authorization may be in the form of bus passes, cab or van services, or mileage reimbursement. Must complete a Medical Transportation Application in order to be eligible.

 

Links for NET services:

Client Rights and Responsibilities

Medical Provider Verification Form

NET Application

NET Customer Request Form

 

CONTACT US

Please contact 419-999-0224 for additional information.

State Hearings

If you disagree with any action on your case or if you believe ACJFS has not taken an action it should have, you may request a hearing by phoning the ODJFS Consumer Access Line at 1-866-635-3748 or by emailing your request to BSH@jfs.ohio.gov or contact Allen County directly at (419) 228-2621 or Allen_CDJFS_Hearings@jfs.ohio.gov.

To find out more about state hearings, please review the state hearing section of the ODJFS Program Enrollment and Benefit Information document.

The Bureau of State Hearings is excited to announce that the redesigned SHARE (State Hearings Access to Records Electronically) Portal has been deployed this week.  The SHARE Portal allows appellants to directly access their state hearing information electronically.  The login and password for the SHARE site is the same as the login and password for the Ohio Benefits Self-Service Portal.  The Portal will provide access for appellants and authorized representatives to: review state hearing records, request a hearing, upload a document, request a reschedule,  or withdraw a hearing.   The website is https://hearings.jfs.ohio.gov/SHARE/.  Please check out the website when  you have the opportunity.  New language regarding the SHARE Portal is scheduled to be added to the Ohio Benefits Notices as of the release of 3.5.1 on October 14.  With this change, we are hoping to increase use of the SHARE portal as the primary way for appellants to request and manage their state hearing information.

This video, which is also included on the Portal, explains how appellants can use the SHARE Portal:  https://youtu.be/IqmbYL-4aF4.

Learn About Medicaid in Ohio

The Ohio Department of Medicaid has comprehensive Medicaid information for consumers. Although Allen County residents will likely need to apply through Allen County Job and Family Services, the state information can help individuals be better informed. Individuals can learn the various types of Medicaid, how to obtain Medicaid coverage, about Managed Care Plans, what your benefits include, which services are covered and answers to frequently asked questions.

LEARN MORE

Ohio Department of Medicaid’s new website tutorial – CLICK HERE

Long-Term Care and/or In-Home Waiver Care

Long-Term Care (LTC) is a variety of services and supports that help an individual meet their personal care needs. LTC services do not need to be medical care, but includes assistance with everyday life tasks and can be considered into two categories:

  1. Institutional or facility services, which include inpatient, comprehensive services in a nursing facility, ICF-IID, or other medical institution for more than 90 days. The comprehensive care includes room and board.
  2. Home & Community-Based Services (HCBS or Community), which includes waiver and PACE services. HCBS allows individuals to receive services in their own home or community and does not include payment for room and board.

Those wanting to apply for Long-Term Care and/or In-Home Waiver must submit a 7216 application and note they are applying for Long-Term Care services.

Additionally, ensure that you complete and send us the Resource Questionnaire so that we can get an understanding of your resources.

Qualified Income Trust Form – If your income is above 300% of the current Supplemental Security Income benefit payment rate, you will be required to set up a Qualified Income Trust to become Medicaid eligible.

Long Term Care Resident Addendum – If we are unable to contact you for an interview, this will need to be completed.

Long-Term Care/In-Home Waiver Care Contact Information:
Phone:  (419) 228-2621
FAX:  (419) 999-0301
Email:  Allen-Med-NH@jfs.ohio.gov

ACJFS LONG TERM CARE BROCHURE

Healthchek and Pregnancy-Related Services (PRS)

Early and continual prenatal care plays an important role in positive pregnancy results and the birth of a healthy baby. Ohio Medicaid’s PRS (Pregnancy Related Services) program was developed to improve and maintain the health of the pregnant woman, increase her chances for a healthier baby and promote positive birth outcomes. This is a free service to all Medicaid eligible pregnant women and is also known as the Healthy Start Program for pregnant women. An application for eligibility can be completed at your local County Department of Job and Family Services (CDJFS), online through the Self Service Portal or by calling the Medicaid Consumer Hotline at 1-800-324-8680 (TDD 1-800-292-3572).

Eligibility
A woman may be eligible for PRS from the date she suspects that she is pregnant and reports it to her County Department of Job and Family Services through 60 days after the end of her pregnancy. She may also have eligibility for three months prior to her date of application (retroactive eligibility).  If there are problems determining a woman’s initial eligibility for the program, Expedited Medicaid may also be available for 60 days for any pregnant woman who verifies her pregnancy to Allen County Job and Family Services, but is required to submit other verification prior to ongoing approval. Expedited Medicaid services will cover her pregnancy related doctor’s visits and prescriptions.

Covered Services
The enhanced services of the PRS program include referrals, individual pregnancy counseling and education, group education, case management, nutrition intervention, transportation to Medicaid reimbursable appointments and fetal delivery.

At Allen County Department of Job and Family Services, we have designated PRS coordinators to provide case management, referrals and transportation services.

Healthchek Services for Children Younger than Age 21

Healthchek is Ohio’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program. It is a service package for babies, kids, and young adults younger than age 21 who are enrolled on Ohio Medicaid. The purpose of Healthchek is to discover and treat health problems early. If a potential health problem is found, further diagnosis and treatment are covered by Medicaid.

Healthchek covers ten check-ups in the first two years of life and annual check-ups thereafter and offers a comprehensive physical examination that includes:

  • medical history
  • complete unclothed exam (with parent approval)
  • developmental screening (to assess if child’s physical and mental abilities are age appropriate)
  • vision screening
  • dental screening
  • hearing assessment
  • immunization assessment (making sure child receives them on time)
  • lead screening; and
  • other services or screenings as needed

If your child(ren) are enrolled on Ohio Medicaid, Healthchek services are available to them. If you are younger than age 21 and are also enrolled, you can receive Healthchek services, too.

For more information:

If you still have questions about Healthchek, send the State a note through the Healthchek Questions form or call (419) 999-0202.

Allen County Healthchek and Pregnancy Related Services Useful Links

Find below a listing of possible resources for assistance with clothing, housing, food, and other services in Allen County.

Women Infants and Children
940 N Cable Road, Suite 4
Lima, OH 45805
419-224-8200

Allen County Health Department
219 E Market St
Lima, OH 45801
419-228-4457

Allen Metropolitan Housing
Section 8 Program
600 S. Main St.
Lima, OH 45804
419-228-6065

West Ohio Community Action Partnership
540 S. Central Ave
Lima, OH 45804
419-227-2586

United Way of Lima
616 South Collett Street
Lima, OH 45805
419-227-6341

Help Me Grow
967 Bellefontaine Ave
Lima, OH 45804
419-665-3322

Voter Registration

If you are applying or re-applying for food/cash/medical assistance, or moving, complete a Voter Registration form by clicking here. Please read instructions carefully. For further information, you may consult the Secretary of State’s website at: www.OhioSecretaryofState.gov or call (877) 767-6446.

Additional Resources

Allen County has several other resources available that can be found HERE.

Contact Us

Please use the following information to contact us about medical assistance:

Phone: (419) 999 – 0255

Fax: (419) 999 – 0301

Email: allen-med-nh@jfs.ohio.gov

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