Pregnant Women & Children
Medicaid is a federal and state financed health care program which is administered by the states. It provides medical to low-income persons who meet the eligibility criteria. The Ohio Department of Job and Family Services (ODJFS) administers the program in Ohio, through the county departments of job and family services.
The following groups may be eligible for Medicaid;
Medicaid Programs for Families,
Low Income Family (LIF)
Healthy Start Expansion
about the program, click in the link below:
To apply, click on the link: http://www.jfs.ohio.gov/ohp/cbi
Please visit the Web Site for Ohio Healthy Start Program
The Ohio Department of Job and Family Services is the State agency responsible for the implementation and administration of the Ohio Medicaid program. Ohio Medicaid has incorporated the used of managed care since 1978 to enhance the system accountability for access and quality as well as to achieve greater cost predictability.
Managed care offers an opportunity to assure access to primary care providers, emphasize preventive care and encourage the appropriate usage of medical services in the most cost effective manner.
Medicaid Managed care plans in Ohio are licensed as health insuring corporations through the Ohio Department of Insurance. These plans are contracted with the Ohio Department of Job and Family Services and provide all the same services that are received with the Medicaid card with some positive differences:
24 hour toll-free medical
Individuals and families who are eligible for Healthy Start and Healthy Families Medicaid must enroll in one of the participating Managed Care Plans (MCP) in order to receive health care services.
Mandatory County managed care plan (MCP) members must:
Receive most of their health care through the panel of doctors, hospitals, pharmacies and other health care providers that contract with the MCP,
Mandatory county MCP members may go to a non-MCP provider for emergency care, or for service provided at a federally qualified health center/rural health clinic, family planning providers as listed in the provider directory, community mental health centers and the Ohio Department of Alcohol and Drug Addiction Services facilities that are Medicaid providers.
Choose a primary care provider, or PCP and agree to see their PCP or providers the PCP refers them to for the needed care.
Mandatory county MCP members may ask the MCP for help in accessing services, such as help in finding a doctor, or making an appointment.
What managed care plans are available in Stark County for the affected groups?
with Mercy Medical, Affinity Medical Center, Doctors' Affinity Hospital and Alliance
Community Health Plan (affiliated
with Aultman Hospital, Mercy Medical, Affinity Medical Center, Doctors'
Affinity Hospital and Alliance City
When and how does a consumer join a managed care plan?
To join a managed care plan now, the consumer can learn about the choices of managed care plans in Stark County and receive help in choosing a health plan:
Medicaid Programs for Individuals
Spend Down Medicaid
AGED, BLIND &
DISABLED FACT SHEET
Medicare Beneficiary (QMB)
Specified Low-Income Medicare Beneficiary (SLMB)
Qualified Individuals 1 (QI-1)
Qualified Working Disabled Individual (QWDI)
Buy-In for the worker Disabled (MBIWD)
Learn more about the program, click on the link:
To apply, click on the link: http://www.jfs.ohio.gov/ohp/MBIWD app.stm
In 2005, the Ohio General Assembly adopted legislation requiring the enrollment of certain Medicaid consumers who are aged, blind or have disabilities (ABD) into the Medicaid managed care program.
Managed Care offers an opportunity to assure access to primary care providers, promotes prevention and wellness and provides quality care in the most cost effective manner.
ABD consumers who will be excluded at this time from
Medicaid managed care include:
It is important to note that the ABD members enrolled in a
managed care plan (MCP) will continue to receive all medically necessary
health care services. Managed care plans often provide additional
services that are important to ABD consumers. These services
What managed care plans are available in Stark for the ABD Medicaid consumers?
>Buckeye Community Health Plan (affiliated with Alliance Community Hospital, Aultman Medical Foundation, Doctors' (Affinity) Hospital, Mercy Medical Center) Web site: http://bchpohio.com
>CareSource (affiliated with Alliance Community Hospital, Mercy Medical Center) Web site: http://www.caresource-ohio.com
>Unison Health Plan of Ohio (affiliated with Affinity Medical Center (Massillon Campus), Alliance Community Hospital, Doctors' (Affinity) Hospital, Mercy Medical Center) Web site: http://www.unisonhealthplan.com
To join a managed care plan, the consumer can learn about the choices of managed care plans in Stark County and receive help in choosing a health plan:
>CALL 1-800-605-3040, Monday through Friday, 8:00am to
AND COMMUNITY BASED SERVICES
Residential State Supplemental Program (RSS)
Home And Community Based Services (HCBS) Waivers
Medicaid waivers can provide nursing care, personal care, adult day care, and respite care. The waivers provide these services to people who would otherwise be in a nursing home. Medicaid usually cannot cover these services.
HOME AND COMMUNITY-BASED
WAIVER FACT SHEET
Nursing Home Care
MEDICAID ESTATE RECOVERY
Medicaid Hospice Program
At Risk Pregnancy
& Cervical Cancer Project
To learn more about the program click on the link below:
To apply click on the link below: