This is a bleg for information about Ohio Medicaid for a segment of my wife’s extended family. Their circumstances have dramatically changed in the past year or so from upper middle class to destitute. The remaining parent is working thirty hours a week at a retail position, and the two kids are currently uninsured because the parent does not know how to navigate the system. I just found out about those things last night after a long phone call from a cousin in law who knows that I am the family “insurance guy”.
I know the kids are eligible for CHIP at the very least. I am fairly confident that they are all eligible for Medicaid expansion. What I need help with is figuring out what the legacy Medicaid eligibility requirements are so I can start pointing them in the right direction as well as figure out if there are asset tests they need to be concerned about.
Linda
http://www.ohioelderlaw.com/portal/TheOhioLegacyTrust/tabid/684/Default.aspx
Found this, hope it’s useful
Ohio Mom
Here in Cincinnati, the Children’s Hospital (Cincinnati Children’s Hospital Medical Center to be exact) has a department that is dedicated to helping families enroll in Medicaid, CHIP. etc. They are called Family Financial Advocates.
I have heard them speak at disability workshops (my kid is on the autism spectrum) and they are GENUISES. They know the systems inside and out. And since the hospital believes in “family-centered medicine,” I assume they also know about signing up the parents (no use in trying to help a kid when their parents are too sick to do anything).
I think they would be more than willing to point you in the right direction. Their phone number is 513-803-6500 and their email is FFA at cchmc dot org.
JPL
Richard, Your post is the reason that a safety net is so important. I hope that your family finds the help they need to navigate the system.
currants
I think this website might be useful http://medicaid.ohio.gov/FOROHIOANS/GetCoverage/WhoQualifies/ExtensionFAQ.aspx but I sort of can’t imagine you haven’t already gone through it.
currants
@currants:
FYI adults over 19 up to 138% of the Federal Poverty Level –up from 90% before Jan 2014.
and “Does the newly covered population have any asset limits that can prevent someone from qualifying?
There are no asset tests or asset restrictions for the newly eligible population because the newly covered population falls within the MAGI eligibility rules. “
richard mayhew
@currants: That is the question — I know if they are newly eligible solely due to expansion, there are no asset tests. I am not sure if there are asset restrictions if the kids and more importantly the adult qualifies for Medicaid under the Legacy rules.
currants
@richard mayhew: Note to Currants: Reading is Fundamental….
rikyrah
you are a good egg, Mr. Mayhew.
Tenar Darell
I’d also check and make sure they are working on getting food stamps too, because 30 hrs/ week retail is not enough for a family of 4. (And they may be too embarrassed to ask for them if they just recently had all this trouble come crashing onto their heads).
a hip hop artist from Idaho (fka Bella Q)
@richard mayhew: As Ohio Mom advised, I believe your best avenue for answers is Cincinnati Children’s. Given its status as the premier pediatric facility in the region, CCHMC should have the information you need. If for some reason that is unsuccessful, post the county of residence (or email me at the blog email contact) and I’ll see if I can direct you to the local information.
I might have some useful state contacts from the expansion campaign. Now of course, we’re worried about the budget fight over continued expansion.
NZ Expat
We’re coming back to the States after six years away. Husband will be on Medicare but I will need one year of insurance and it is bizarre and incomprehensible to see the money and time spent on trying to negotiate a for-profit health care system after living with national health care. I suppose you all are used to the system but what an immoral squandering of health, time and money. I’m astounded but am told to be thankful because before ACA, I wouldn’t be able to get insurance at any price. I’m relieved but mostly think if Americans truly understood what life is like with health care uncoupled from a job could be like, we might have a true revolution. I want this stay in the US to be short, yet it is where my kids live.
Barbara
I am not sure which of these statistics will help you the most, but you can get eligibility limits for each program, and a variety of other metrics here: http://kff.org/state-category/medicaid-chip/?state=OH
According to this website, Ohio is one of the states that allows authorized qualified entities such as hospitals, community health centers, and schools to make presumptive eligibility determinations for Medicaid and/or CHIP and extend coverage to individuals temporarily until a full eligibility determination is made. You could call FQHCs or other community organizations to identify an entity qualified to make PE determinations that is reasonably close to where the family lives.
Barbara
Try here: https://benefits.ohio.gov/ (which has an eligibility determination site)
Also, try here: http://medicaid.ohio.gov/FOROHIOANS/FinancialRequirements.aspx
I think these are the legacy program requirements:
Programs for Children, Families, and Pregnant Women
Ohio Medicaid offers three programs for children, pregnant women and families with limited income to get health care. Once eligible for Medicaid, each child (birth through age 20) will have access to an important group of services known as Healthchek.
Healthy Start
Healthy Start (also called SCHIP) is a Medicaid program available to:
Uninsured children (up to age 19) in families with income up to 206% of the federal poverty level.
Insured children (up to age 19) in families with income up to 156% of the federal poverty level.
Pregnant women in families with income up to 200% of the federal poverty level.
Healthy Families
Healthy Families is a Medicaid program available to:
Families with income up to 90% of the federal poverty level and a child younger than age 19
Medicaid for 19 and 20 Year Olds
Medicaid for 19 and 20 Year-Olds is a Medicaid program available to:
Individuals who are age 19 or 20 years old whose countable income does not exceed 44% of the federal poverty level.
Unemancipated individuals who live with their parents or who are temporarily absent from their parents’ home are considered to be financially dependent upon their parents and parent income is used in the eligibility determination.
Kathleen
@rikyrah: What rikyrah said. You are a treasure, Mr. M. Another suggestion I would have is to contact Sherrod Brown’s office. I hear he has oustanding case workers and they may be able to provide you with some leads as well; though he is not a state official, I’m sure he’s schooled himself on the implementation of ACA/Medicaid expansion in Ohio.
Also, here is a link to Buckeye Insurance, a Medicaid provider in Ohio. I talked with one of their reps and she was very helpful and knowledgeable.
http://www.buckeyehealthplan.com/
J R in WV
Richard,
Wishing your family the best of luck in getting the best possible health insurance deal for your in-laws!!
Thanks for all you have done to inform the B-J population about ACA – Obamacare! I remember when the Republicans started calling the new ACA plain old Obamacare, and hoping that it would be a great success, like Social Security and Medicare, named for the President who made it happen!
Driving Republicans crazy for decades to come. Imagine if Republicans had named Medicare – LBJ-Care?
Astounding!
Again, best of luck!
Ohio Mom
@NZ Expat: Are we “used to this system”? I don’t know if most people have ever imagined it could be different.
But for those of us who have an inkling of what it’s like in other industrialized nations, it is hard not to resent the time and energy suck, and also the nagging feeling that we are on the losing end. No matter how sharp you might think you are, you have to know in your heart that the insurance company’s actuaries are going to run circles around your best guesses.
Even after you get coverage, the wrangling with the system never stops — is this covered, is that covered? Or the insurance announces it’s not going to pay for a particular medication anymore and you’re on the merry-go-round of testing out substitutes they will pay for (wrote the person with an asthma flare because she got kicked off the maintenance stuff that worked and the substitute didn’t).
Denali
@NZ expat,
We just returned from a visit to NZ and were so impressed with the healthy people there and the sensible political system. I know it is not fair to compare our much larger and more diverse country with NZ, but the contrast is striking. They are committed to be nuclear free and are doing well economically. There are problems, but they are committed to dealing with them sensibly instead of denying that they exist. I would be tempted to emmigrate if we were not so old and it were not so complicated.