Medicaid Managed Care

Medicaid Managed Care became effective in Fairfield County on December 1, 2006 Managed Care is medical coverage provided to a consumer in place of Medicaid or the Healthy Families/Healthy Start program. Managed Care Plans (MCP) contract with physicians, hospitals, and other medical providers to build and expand a network of care for consumers. Fairfield County is considered to be in the Central region. This will allow consumers to access care in 18 counties within the Central region. Fairfield County became a mandatory Managed Care county effective December 1, 2006.
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Healthy Start/Healthy Families offer free and low-cost health coverage to families, children (up to age 19) and pregnant women. Coverage includes: doctor visits, hospital care, pregnancy related services, prescriptions, vision, dental, substance abuse, mental health and more. Most families will receive coverage at no cost to them. Some families, depending on family income, will be required to pay a small premium. An application is submitted to determine eligibility.

Medicaid Programs

There are numerous Medicaid programs administered by each County Department of Job and Family Services. The main categories of Medicaid that the Fairfield County Job & Family Services, Community Services Division, determines eligibility for is Healthy Start, Healthy Families and Transitional Medicaid. Medical coverage is based on financial and other eligibility requirements and varies according to household type. Many families may qualify for coverage for their child(ren) even when they are working. Family income determines if they are eligible for these programs. General information about these programs is listed below.

Healthy Start (also known as MA P) is free and low-cost health coverage for children from birth to age 19 and for pregnant women who qualify based on family income.

Healthy Families (also known as MA C) provides no-cost health coverage for the entire family - parents and children.

Transitional Medicaid (also known as MA Y) is a type of medical coverage that allows families to transition to work and still be eligible for medical coverage. Any family member who has received at least three of the previous six months of Healthy Families (MA C) is automatically eligible for six months of extended coverage. An additional six months may be available for those who are income eligible during these extended months.

Healthy Start, Healthy Families and Transitional Medicaid cover these services:
  • Doctor Visits
  • Hospital Care
  • Substance Abuse
  • Dental Care
  • Prescriptions
  • Immunizations
  • Vision Services
  • Mental Health
  • Some Other Services
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Applying for these programs is simple. It requires an application, called a Combined Program Application (CPA). Applicants should submit their application with any available documents that support their answers to questions on the CPA. Applying for medical-only does not require a face-to-face interview, as other categories of assistance do.

The previous description is NOT an all-inclusive list of medical programs administered by Fairfield County Job & Family Services. The other two categories that the Community Services division administers is Medicaid for disabled individuals and young adults 18 up to 22 years of age who qualify. These categories of assistance are also known as MA D and MA T, respectively. These programs require the same application as those applying for Food Stamps and Ohio Works First (OWF) Cash Assistance.