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What is Medicaid?
Medicaid is a
federal program allowing eligible Ohioans with low incomes to receive
needed health services. Services available for payment by Medicaid are
unique to each state and are approved under what is called a State Plan.
Ohio’s State Plan covers services such as hospital stays, check-ups for
children and for pregnant women, nursing services, medication coverage,
and other services for people who are Medicaid eligible. Medicaid does
not pay money to you; instead, it pays a provider that delivers
healthcare services to you. Each month, you should receive a Medicaid
card to show you are covered. To find out more about becoming a Medicaid
recipient, please contact your local County Board of MRDD or your local
county Department of Job and Family Services.
Waiver services,
also known as "Medicaid waivers," are programs offered through the Ohio
Department of Job and Family Services (ODJFS), the Ohio Department of
Mental Retardation and Developmental Disabilities (ODMRDD), and the Ohio
Department of Aging. Waivers provide community services to people who
would otherwise be institutionalized. Currently, Ohio has several
waivers and this section offers information about these programs.
However, you should contact the agency that administers the waiver to
verify the information provided and for more specific information about
eligibility and services.
Names of the Waivers
Currently, Ohio has
several waivers that are administered by either the Ohio Department of
Job and Family Services, the Ohio Department of Mental Retardation and
Developmental Disabilities, or the Ohio Department of Aging. The
following lists the names of these waivers and the agency that
administers them.
Individual Options Waiver - Ohio
Department of Mental Retardation and Developmental Disabilities
Level One Waiver - Ohio
Department of Mental Retardation and Developmental Disabilities
Ohio Home Care
Waiver - Ohio Department of Job and Family Services
PASSPORT Waiver
- Ohio Department of Aging
Transitions Waiver
- Ohio Department of Job and Family Services
Eligibility Requirements
The following lists
the eligibility requirements for each waiver. Because there are many
factors that go into determining financial eligibility, such as the
extent of the person's disability, the person's prognosis, and the
person's assets, the term "specific financial criteria" is used for each
waiver. Specific information about financial criteria can be provided by
the agency that administers the waiver. For some of the waivers, an "ICF/MR"
level of care is required. ICF/MR stands for "intermediate care facility
for a person with mental retardation or a developmental disability"
level of care.
Name of Waiver, Eligibility Requirements
Individual Options Waiver
·
Specific financial
criteria
·
ICF/MR level of care
·
All ages
Level One Waiver
·
Specific financial
criteria
·
ICF/MR level of care
·
All ages
Ohio Home Care Waiver
·
Specific financial
criteria
·
Intermediate level of care
·
All ages
PASSPORT Waiver
·
Specific financial
criteria
·
Intermediate level of care
·
Ages 60 years and older
Transitions Waiver
·
Specific financial
criteria
·
ICF/MR level of care
·
All ages
Services Provided
The following lists
services that may be provided by the waiver. For most waivers, once a
person is approved to receive services, they are allotted a certain
amount of money. The Service and Support Administrator works with the
person to determine which services would benefit the person the most and
the money is allocated in a way to provide the services. So, although
there may be a broad menu of services available through a specific
waiver, that does not necessarily mean the person will receive all of
the services.
Also, although the
funding for services may be approved, the availability of providers for
the services is an on-going issue with many people. The nationwide
shortage of nursing and home health aids is having a direct impact on
the delivery of services to people with disabilities.
Waiver Services
According to Program Name of Waiver; Type of Services:
Individual Options Waiver
·
Respite care
·
Supported employment
·
Adult Day Support
·
Vocational Habilitation
·
Environmental
accessibility adaptations
·
Transportation
·
Specialized medical,
adaptive equipment and supplies
·
Homemaker personal care
·
Social work
·
Home delivered meals
·
Interpreter
·
Nutrition
Level One Waiver
·
Homemaker/personal care
·
Respite (institutional or
informal)
·
Special medical equipment
·
Transportation
·
Supported employment
·
Adult Day Support
·
Vocational Habilitation
·
Environmental
accessibility
·
Personal emergency
response system
·
Emergency services
Ohio Home Care Waiver
·
Respite care
·
Adult day health
·
Environmental
accessibility adaptations
·
Transportation
·
Personal emergency
response system
·
Adaptive and assistive
devices
·
Daily living services
·
Nursing services
·
Home delivered meals
·
Therapies
PASSPORT Waiver
·
Homemaker/Personal care
·
Adult day health
·
Environmental
accessibility and adaptations
·
Transportation
·
Specialized medical,
adaptive and assistive equipment, and supplies
·
Chore services
·
Social work and counseling
·
Nutritional consultation
·
Home-delivered meals
Transitions Waiver
·
Respite care
·
Adult day health
·
Environmental
accessibility adaptations
·
Transportation
·
Personal emergency
response system
·
Adaptive and assistive
devices
·
Daily living services
·
Nursing services
·
Home delivered meals
·
Therapies
How to Apply for Waiver Services
The following lists
the agencies where you can apply for waiver programs. It is wise to call
first to make an appointment and to verify what information you will
need for the initial interview. The interview usually requires copies of
lots of paperwork, such as financial, medical, and housing records.
Name of Waiver Where to Apply
Individual Options
Waiver Apply at your county board of MR/DD.
Level One Waiver
Apply at your county board of MR/DD.
Ohio Home Care Waiver Apply at
your county department of Job and Family Services.
PASSPORT Waiver Apply at
your county department of Job and Family Services or at your Area Agency
on Aging.
Transitions Waiver
This waiver is not open for enrollment. It is currently used for people
who are on the Ohio Home Care Waiver, but who have an ICF/MR level of
care.
A list of benefits
from Ohio’s Medicaid program can also be found by visiting Job and
Family Services Helping Ohioans at:
http://jfs.ohio.gov/ohp/consumers/benefits.stm.
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