Affordable Care Act & Ohio Medicaid Changes

We received the following information from the Licking County Department of Job and Family Services regarding access to medical insurance with the recent changes to healthcare laws through the Affordable Care Act and the expansion of Ohio’s Medicaid eligibility.

To accommodate the changes and expansion of eligibility, Ohio is rolling out a new system for applying for Medicaid in Licking County and throughout the state. The new system is available to consumers at www.benefits.ohio.gov.

The State of Ohio has announced that www.benefits.ohio.gov will be available for consumers to apply for Medicaid under expanded eligibility starting on December 9, 2013, for Medicaid coverage to begin on or after January 1, 2014.

Additional categories of Medicaid will be rolled out on www.benefits.ohio.gov in phases for approximately the next 12 months. Until all phases are complete, the application for some categories of Medicaid assistance will only be available through the current online system (odjfsbenefits.ohio.gov) or by visiting Licking County Job & Family Services (LCJFS).

No Wrong Door

Licking County Job and Family Services (LCJFS) and the State of Ohio have embraced a “no wrong door” policy for individuals and families seeking Medicaid assistance. Considering the convenience for the customer, LCJFS encourages most customers to apply for Medicaidonline at www.benefits.ohio.gov at an available computer or the LCJFS office’s community resource room. Customers, who are uncomfortable completing the application online, may visit the LCJFS office for a paper application. Customers may also apply by calling the State of Ohio’s Medicaid hotline at 800.324.8680.

Licking Countians who are not Medicaideligible should visit the federal Marketplace to shop for private health insurance by visiting www.HealthCare.gov. In the spirit of “no wrong door,” the federal Marketplace will alert applicants to potential Medicaid eligibility. In this case, the system is designed to transfer the customer’s application to www.benefits.ohio.gov to explore Medicaid eligibility. Those who start their applications on the Medicaid eligibility system (www.benefits.ohio.gov) and are determined ineligible for Medicaid will have their applications transferred to the federal Marketplace to shop for private insurance.

Who Should Use www.benefits.ohio.gov?

While www.benefits.ohio.gov is up and running, currently it can only be used to determine Medicaid eligibility for new applicants who wish to start their coverage on or after January 1, 2014. Current Medicaid recipients and those looking for coverage to start before January 1, 2014, can apply or make changes to their cases by using the current online portal (eGateway) at www.odjfsbenefits.ohio.gov, visiting the LCJFS community resource room at 74 South Second Street in Newark, or by calling the agency at 740.670.8988. Those enrolled or interested in applying for Medicaid – Aged, Blind, or Disabled (ABD), long term care, or Medicaid waiver should also continue to use the current application process, including the eGateway online system or by visiting our office. These categories of Medicaid are scheduled to be added to the new eligibility system at the end of 2014.

Ohio’s Medicaid Expansion

The recent Medicaid expansion will extend eligibility to Ohio residents who are between the ages of 19 and 64 without minor children and earn up to 138% of the Federal Poverty Level (FPL). Parents with minor children will also see the income limit for Medicaid eligibility rise to 138% of the Federal Poverty Level, up from its current 90% of the FPL.

Changes also include a switch to the MAGI methodology for determining Medicaid eligibility. “MAGI” is an IRS term that refers to “Modified Adjusted Gross Income.”

Income Limits for Ohio’s Medicaid Expansion

The numbers below indicate HOUSEHOLD SIZE and 138% FPL ANNUAL income.

1 = $15,856
2 = $21,406
3 = $26,952
4 =$32,499
5 = $38,047
6 = $43,594
7 = $49,142
8 = $54,689

*Federal Poverty Level Data as of 11/6/13 .

Applying for Non-Medical Assistance

The online application found at www.benefits.ohio.gov eventually will be expanded to include all income-tested Health and Human Services programs, like SNAP (food stamps) and OWF/TANF (cash assistance). However, the transition to a completely integrated eligibility determination system is not scheduled to be completed until mid-2015. Until then, those seeking non-medical assistance should continue to access the current online application (eGateway) by visiting www.odjfsbenefits.ohio.gov, visiting the LCJFS office, or by calling the agency at 740.670.8988.

Click here to access a flowchart to help navigate the application process for Medicaid at each phase.

Written by

No Comments Yet.

Leave a reply

You must be logged in to post a comment.