Ohio hospitals are paid for health care services they provide by three categories of payers—commercial insurers, government programs and individual patients. Private insurance coverage is primarily provided through employer-sponsored programs in Ohio. Government payers include Medicare, Medicaid, Veterans Administration, Bureau of Workers Compensation and the military. Patients who have not purchased coverage or applied for coverage through government programs are billed directly for the services provided.
OHA has worked with the private payer community to aggregate in one location the plans’ changes related to COVID-19 testing and claims.
As Ohio's population ages, Medicare's role insuring Ohioans 65 and older continues to grow. The federal program also covers certain younger people with disabilities and end-stage renal disease.
Ohio expanded eligibility to Medicaid in 2014. The program provides health care coverage for Ohio's poor and disabled citizens.
Ohio hospitals help fund the state's share of Medicaid. Read more about how the program has reached a tipping point at the current franchise fee rate.
HCAP provides medically necessary free hospital-level care for low-income Ohioans and supplemental payments for hospitals with a disproportionate share of uncompensated care.