Fall 2016 Medicaid Article


Beginning August 1, 2016, Ohio Medicaid will no longer perform a separate disability determination as part of the eligibility process.  This means Ohioans who receive Supplemental Security Income (SSI) will be automatically enrolled in Medicaid coverage.  Other changes include:
  • The income limit for individuals who are aged, blind, or disabled will be raised to the Federal Benefit Rate (FBR).  This is approximately $733 gross income per month.
  • The resource limit will be raised from $1,500 to $2,000 for an individual and increased to $3,000 for a couple.
  • Individuals will no longer have the option to spend down each month for Medicaid coverage.  

Individuals who previously were on spend down Medicaid will see the following types of changes:

  • Individuals with income under the FBR of $733 will have full Medicaid coverage and will no longer need to spend down.
  • Individuals with income between the FBR of $733 and 138% Federal Poverty Level (FPL) or $1,367/month  and who also have Medicare will no longer be eligible for Medicaid benefits.  This change will not affect their Medicare coverage, and they may remain eligible for assistance in paying for their Medicare costs.
  • Individuals with income between $733 and 225% FPL or $2,199 gross monthly income and diagnosed with a serious and persistent mental illness may qualify for Specialized Recovery Services, a new Ohio Medicaid benefit.
  • Other individuals with income greater than $733 will apply for coverage through the federal Health Insurance Marketplace (Healthcare.gov) and may be eligible for discounted health care coverage.
  • Individuals receiving long-term care services with an income over $2,199 will also see a change.  They will remain eligible for Medicaid health coverage by depositing excess income into a Qualified Income Trust (QIT).  The Ohio Department of Medicaid has hired Automated Health Systems to reach out to individuals about QIT's and answer questions.  Automated Health Systems can be reached by email at OhioQIT@automated-health.com or by phone at 1-844-265-4722.  For more information, go online:  Medicaid.ohio.gov/ddr.