Medicaid Spend Down in Ohio

Medicaid provides payment for health care services on behalf of eligible low-income persons and individuals with limited income and high medical expenses. Payments are made directly to the health care providers. In some cases, persons may qualify for payment of medical services that were provided up to three months before the month in which a Medicaid application was completed.

In order to qualify for this benefit program, you must be a resident of the state of Ohio, a U.S. national, citizen or permanent resident in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. If very low income, you must also be pregnant, have a child(ren) with a disability, or be responsible for children under the age of 19 years.

• You can have a car, bank account, and a home and still qualify for Medicaid in Ohio. DMMA does not look at any of your resources when determining your eligibility for Medicaid.
• You can work and still qualify for Medicaid.
• Some persons can have other insurance and still receive Medical Assistance.
• Low-income uninsured adults between the ages of 19 and 65 may qualify for Medicaid.
• Certain children living with stepparents, grandparents, or siblings with income may receive Medicaid.
• Needy families with children may be eligible for Medicaid if they are part of Temporary Assistance for Needy Families.
• When a family getting a welfare check starts working and leaves welfare they still may receive Medicaid.
• Low-income pregnant women and children under age 19 may qualify for Medicaid.
• Most women of child bearing age may be eligible for birth control and family planning services for up to 24 months after their regular Medicaid stops.

Medicaid furnishes medical assistance to eligible low-income families and to eligible aged, blind and/or disabled people whose income is insufficient to meet the cost of necessary medical services. Medicaid pays for: doctor visits, hospital care, labs, prescription drugs, transportation, routine shots for children, mental health and substance abuse services.

Any individual, who is an applicant or recipient of SSI/Medicaid, and in the “spend down” process, should meet with a Ohio funeral director. During a prearrangement conference, the individuals should select which burial or cremation services and funeral merchandise he or she desires as disclosed on a “General Price List.” The funeral director will then note these selections on an itemized statement (commonly known as a “Preneed Itemization Statement”), which will reflect the current retail cost of the merchandise and funeral or cremation services selected. The next step is funding the funeral arrangements. Funeral prearrangements will qualify as prepaid funeral resource exclusion if the funds are placed in an irrevocable prepaid funeral account funded with burial insurance.