Medicaid feature image Source: Ohio Department of Medicaid

Medicaid

Medicaid and the Children’s Health Insurance Program provide health care coverage for people with disabilities and for low-income Ohioans — families and children, pregnant women and the elderly. Today, one in four Ohioans is enrolled in Medicaid, with 83,000 active providers caring for 3.1 million individuals.
 
The Medicaid program is jointly funded by states and the federal government. In Ohio, the current FY 2022 Federal Medical Assistance Percentage, or FMAP, for most Medicaid expenditures is 70.30%; 79.21% for children; and 90% for Medicaid expansion.

FINANCE NEWS - MEDICAID

Connect here to view Medicaid-specific Finance News prepared by OHA's Health Economics & Policy team.

Ohio Large Provider Group

OHA members can log in and view details of quarterly meetings of the Large Provider Group here.

MEDICAID AND OHIO HOSPITALS

Medicaid was the payer in 23% of Ohio hospital encounters in 2020. Enrollment in Medicaid jumped to 27% of the state's population during the COVID-19 pandemic as many lost employer-sponsored coverage.

MEDICAID EXPANSION

Ohio expanded Medicaid program eligibility in 2014 to include additional uninsured adults with incomes up to 138% of the federal poverty level.
 
To be eligible for Medicaid coverage, individuals must:

  • Be a United States citizen or meet Medicaid citizenship requirements
  • Have or get a Social Security number
  • Be an Ohio resident
  • Meet financial requirements according to Modified Adjusted Gross Income

WHO IS COVERED

The Ohio Department of Medicaid reports beneficiaries and expenses by four eligibility categories. Each group has its own income requirements:

  • Covered Families and Children, or CFC—Pregnant women, infants and children
  • Group VIII, expansion population—Individuals at or below 138 percent of the federal poverty level, including childless adults
  • Aged, Blind and Disabled, or ABD—Individuals with disabilities
  • Other—Including elderly

WHAT MEDICAID COVERS

Medicaid assists in paying for:

  • Inpatient and outpatient hospital care
  • Physician, midwife and specific nurse practitioner care
  • Laboratory and x-ray services
  • Nursing home and home health care
  • Early and periodic screening, diagnosis and treatment for children under age 19
  • Family planning
  • Rural health clinics/federal qualified health centers
  • Prescription drugs