Eligibility for Medicaid in Ohio


“What are the requirements for Medicaid in Ohio?” is one of the most common questions asked by residents interested in the program. Learning how to qualify for Medicaid is crucial before a resident begins the application process. Not only will you need to be a resident of Ohio, but you must also be a United States citizen in order to qualify for Medicaid. Additionally, in order to qualify for Medicaid, you must also have a Social Security Number. Furthermore, your Medicaid benefits eligibility in Ohio will be determined by your ability to keep the state informed about any changes to your income, household or address. While your eligibility for Medicaid will be reviewed and re-determined every 12 months, you are still responsible for reporting any changes to your caseworker within 10 days from the date of the change. To learn more about determining Medicaid eligibility, review the sections below.

Who is eligible for Medicaid in Ohio?

In addition to the Medicaid eligibility requirements outlined above, Medicaid is reserved for the following individuals. Women who are currently pregnant, infants, and children may be eligible for Ohio Medicaid. You may also meet Medicaid eligibility qualifications if you are a senior citizen of at least 65 years of age or an individual with a disability that has been certified with the Social Security Administration. Lastly, individuals who meet Ohio’s low-income requirements may also be eligible for Medicaid. In any case, to meet the OH Medicaid eligibility requirements and learn how to apply for benefits, you must meet at least one of these criteria.

What are the income requirements for Medicaid in Ohio?

Medicaid eligibility requirements are also based upon your household’s income. Ohio Medicaid’s low-income requirements will be based upon a variety of factors, such as your household size and the ages of those within your household whom are applying for Medicaid. The income requirements for Medicaid will also vary for women who are pregnant, children with another source of medical insurance (like CHIP), and children who have no other medical insurance coverage. When calculating your household income for your Medicaid benefits eligibility, note that Ohio will generally only count income that will be included when filing your federal taxes. As an example, when determining your eligibility for Medicaid benefits, any child support that you receive will not be considered. When it comes to the income qualifications for Medicaid in Ohio, it is also important to note that you must provide your gross monthly income, your income prior to your taxes, in your application. Unless you do not have any income to report, the Medicaid caseworker that is assigned to you may require additional income verification, such as your most recent paystubs.

Click here to download our comprehensive guide and discover specific income requirements for medical assistance, as well as the answer to the common question, “What are the Medicaid application guidelines?”

Ohio Medicaid Benefits Disqualifications

To continue being eligible for Medicaid, as mentioned previously, it is imperative that you keep your assigned caseworker informed about any changes within your household. Should you experience a change such as a move, change in income, change in household size or any other notable change that could affect your Medicaid benefits eligibility, you will need to inform your Medicaid caseworker within 10 days of the change. Should you choose to not report the change, you could put yourself at risk of losing your Ohio Medicaid benefits. If you have Medicaid and a change of income will put your household above the low-income Medicaid eligibility requirements, you may also lose your benefits. Additionally, choosing to not report changes to your caseworker or providing false information on your Medicaid application could result in further penalties. In order to ensure participants’ eligibility for Medicaid benefits, Ohio’s Medicaid program will randomly choose individual cases throughout the year to audit and ensure that these participants are still eligible for Medicaid benefits. Should you be contacted by Medicaid to have your case reviewed, you are required to cooperate with the Ohio Medicaid program in full. Should you refuse to cooperate with a review, your Ohio Medicaid benefits could potentially be terminated.

Additional Ohio Medicaid Benefits That You May Qualify For

If you meet the Medicaid eligibility requirements, you may qualify for assistance with past-due medical bills that had incurred within three months from the date that you applied for Ohio Medicaid. Eligibility is determined on a case-by-case basis, and you will need to talk to your assigned Ohio Medicaid caseworker in order to determine your eligibility and the amount of assistance that Medicaid will provide on your medical bills.

Learn more about all the health benefits you may qualify for by downloading our comprehensive guide.

Ohio Health Services

What Health Care Services Can I Receive in Ohio?

The state of Ohio offers various types of health services to residents, and these health programs include Medicare for the elderly, Medicaid for those in need, and more. To find out how you can apply for these medical assistance benefits, or how you can automatically be enrolled in certain programs, download our comprehensive health services guide.

Who Can Get Health Benefits in Ohio?

While Ohio offers various health service programs for residents of the state, applicants must meet certain eligibility requirements in order to qualify for the programs. Eligibility requirements often depend on income and whether or not the applicant falls into a certain category, such as seniors, pregnant women and children. Find out if you might be eligible for the benefits of these health care programs by downloading our guide.