Medicaid is the national health insurance program implemented in 1965 to provide low-income Americans with free or low-cost health care services. Today, the program covers over 65 million people coast to coast, including families with children, pregnant women, seniors and blind or disabled adults. Each state administers its own customized Medicaid program with funding assistance and oversight by the federal government. Qualifying for Ohio Medicaid The Department of Medicaid administers the Ohio program that serves the health care needs of one in five state residents through managed care plans. Reynoldsburg residents aged 65 or older who are American citizens or legal immigrants can qualify for Medicaid coverage if they have:
- No more than $2,313 in monthly income if single or $4,626 if married and applying with a spouse
- A maximum of $2,000 in countable resources if single or $3,000 as joint-applicant couples
Those who meet the eligibility requirements are enrolled in the aged, blind and disabled managed care plan that provides comprehensive health services, including:
- Primary, acute and specialist care
- Inpatient, outpatient and emergency hospital services
- Ambulance and nonemergency medical transportation
- X-rays, lab and other diagnostic tests
- Long-term care in a nursing facility
Exceptions to Medicaid’s Income and Asset Limitations Seniors who need Medicaid to help cover the cost of long-term care but exceed the income limit may reduce their monthly earnings to the necessary threshold by establishing a
Qualified Income Trust. Once income in excess of the $2,313 limit gets deposited into the trust, it’s disregarded for eligibility purposes. The funds may only be withdrawn to pay for Medicaid-approved medical and care expenses. A married applicant who’s over the income and asset limits may be able to qualify if their spouse isn’t applying for coverage. The applicant’s income may be reduced by up to $3,160.50 and joint assets by up to $126,420 when spousal living and resource allowances are deducted. These allowances are mandated by federal laws to prevent
spousal impoverishment. Reynoldsburg residents can
apply for Ohio Medicaid benefits online or call the program’s consumer hotline at (800) 324-8680 for more information or assistance with their application.
Assisted Living Waiver The Ohio Medicaid program only covers long-term care in nursing homes as an entitlement. However, the state does offer the
Assisted Living waiver program as an alternative to eligible seniors who want to stay in the community. The goal of the waiver is to minimize nursing home admissions and reduce the high cost of care while allowing seniors to enjoy greater independence and a better quality of life. Applicants for the ALW must:
- Meet the residency, functional and financial requirements for Ohio Medicaid
- Be assessed as needing help with daily living activities, such as bathing, grooming, dressing and eating
- Be assessed as requiring a nursing home level of care but be cognitively and functionally capable of living in a community setting
- Have sufficient monthly income to pay the room-and-board portion of assisted living facility fees
Approved applicants receive a range of support services including:
- Community transition assistance
- Medication administration assistance
- Housekeeping and laundry services
- Social and recreational programs
For more information about the ALW program or to apply, Reynoldsburg seniors can contact the
Central Ohio Area Agency on Aging at (800) 589-7277.