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Medicaid Expansion in 2014 • ACA creates new option to expand Medicaid eligibility • Ensures Medicaid coverage for all adults 19-64 with incomes up to 138% FPL • Shifts to simplified way of calculating income to determine eligibility and streamlines the application process

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Page 1: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Medicaid Expansion in 2014

• ACA creates new option to expand Medicaid eligibility

• Ensures Medicaid coverage for all adults 19-64

with incomes up to 138% FPL

• Shifts to simplified way of calculating income to determine eligibility and streamlines the application process

Page 2: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Simplifying Medicaid

• October 1, 2013 - Ohio launch a new Medicaid eligibility system, Ohio Benefits - http://Benefits.Ohio.gov

– Those who do not qualify for Medicaid will be directed to other opportunities for coverage through the federal health insurance exchange.

• 2016 – It is anticipated that Job and Family Service will add eligibility determination to Ohio Benefits for the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) and other programs.

• 12 month eligibility period

http://benefits.ohio.gov/

Page 3: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Medicaid Eligibility Requirements

• Be United States Citizen or meet Medicaid citizenship requirements

• Be an Ohio resident

• Have or be able to obtain a social security number

• Meet certain financial requirements- Medicaid

More information is found at the Medicaid Websitemedicaid.ohio.gov/forohians/GetCoverage/WhoQualifies.aspx

Page 4: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

How to Apply - On Line Applications

www.benefits.ohio.gov

Page 5: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Simple Streamline ApplicationSept 1: Create an account

Page 6: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Enter Demographic Information

Page 7: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Income Guidelines

Page 8: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

In Person or By Mail

In person

By Mail

Page 9: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Over the Phone

Call the Medicaid Consumer Hotline1-800-324-8680

Page 10: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Things Clients Can Do To Get Ready

1. Create their account for Medicaid on Benefits.ohio.gov

2. Start gathering basic information. Family information such as DOB, income, and relationship in the family

3. Make a list of questions you have before it’s time to choose your health plan. For example, How do I select a MCP? Is my doctor in network? My Hospital?

Page 11: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Managed Care Plans

• Buckeye Community Health Plan

• CareSource

• Molina Healthcare of Ohio

• Paramount Advantage

• United Healthcare Community Plan of Ohio

Page 12: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Page 13: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Reporting Life Changes

Individuals must report changes within 10 days

• Address• Marital status• Pregnancy status• Changes in income• Addition or loss of Insurance

Page 14: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Post Enrollment Issues

• Status of application

• Questionable denial

• How do I select a Managed Care Organization – MCP

• Understanding how insurance works

• Medicaid renewals

Page 15: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Medicaid Renewals

• Online – renewal tab

• Call the county hotline to complete a short Supplemental Tax Questionnaire

• Contact the Ohio Medicaid Consumer Hotline

• Complete the paper renewal form

• Passive renewals

Page 16: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

Benefits.ohio.gov

Page 17: Medicaid Expansion in 2014 ACA creates new option to expand Medicaid eligibility Ensures Medicaid coverage for all adults 19-64 with incomes up to 138%

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