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, visit:

• Buckeye Community Health Plan: (866) 246-4358
• CareSource: (800) 488-0134
• Molina Healthcare of Ohio: 1-800-642-4168
• Paramount Advantage: 1-800-462-3589
• United Healthcare: 1-800-895-2017
• If you do not have a HMO Plan, call Fee for Service (FFS): 1-800-324-8680

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

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 your income is above 205% of the Federal Poverty Level, you will be directed to the Federally Facilitated Health Insurance Marketplace to shop for health care.

State Hearings

If you disagree with any action on your case or if you believe WCDJFS 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, emailing your request to BSH@jfs.ohio.gov or contact Wayne County directly at 330-287-5800. To find out more about state hearings, please review the state hearing section of the ODJFS Program Enrollment and Benefit Information document.

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

Non-Emergency Medicaid Transportation

Non-Emergency Transportation (NET) is a statewide program administered by Wayne 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 330-287-5800 for additional information.

Learn About Medicaid in Ohio

The Ohio Department of Medicaid has comprehensive Medicaid information for consumers. Although Wayne County residents will likely need to apply through Wayne 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

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:

• Institutional or facility services, which include impatient, comprehensive services in a nursing facility, ICF-IID, or other medical institution for more than 90 days. The comprehensive care includes room and board.
• 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.

Healthcheck 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 at http://odjfsbenefits.ohio.gov 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 Wayne 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 Wayne 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

Voter Registration

Did you know that Wayne county Job and Family services is a Designated agency for the National Voter Registration Act (NVRA)? That means we have all the information you need if you decide you want to register to vote or need to update any information with the voter’s bureau. Click here to find out more information.