Modified Adjusted Gross Income (MAGI Medicaid)
Frequently Asked Questions:
What does the new MAGI Medicaid insurance cover?
Ohio Medicaid programs provides a comprehensive package of services that includes preventive care for consumers. Some services are limited by dollar amount, number of visits per year, or setting in which they can be provided. You can read more about services at Medicaid.ohio.gov.
How long will it take to get my application processed?
The Affordable Care Act has allowed for expanded eligibility for thousands of Stark County Citizena and as a result we received a large amount of new applications in January 2014. At the current time we are determining eligibility within 60 days of the application date. We expect to improve on this turnaround time and will update the FAQs on a regular basis.
What should I tell my doctor about my coverage?
You can advise your doctor that you completed and submitted an application for medical coverage and that your application is pending. If approved for benefits, coverage will date back to the first day of the application month.
Should I just go online and fill another application?
No, You do not need to complete multiple applications. This will not expedite the process. In fact it may delay the process as there will multiple applications to link before we can move forward with the processing of your case.
Will I get reimbursed for out of pocket payments?
The government will not reimburse you for out of pocket medical expenses. However, your provider has the option to bill for service once coverage is approved. The provider can reimburse some of your out of pocket expenses once they receive payment from Medicaid. However, providers are not obligated to do this.
What am I supposed to do if I need medical attention now?
If you have a medical procedure scheduled within 10 days or you need a prescription/s for life sustainment then you can ask our Customer Service Representatives in the lobby or over the phone to submit an urgent Customer Service Center referral on your behalf. The referral will be reviewed and if you meet the criteria stated above we can expedite the processing of your application.
My child is currently on Healthy Start medical through the agency. Do I have to apply for MAGI?
No you do not need to apply for the child. The child's Medicaid coverage will automatically move to the new system in a scheduled manner. If you, the parent, are not currently covered by any medical insurance, you can apply for MAGI Medicaid via phone, paper or online.
My spouse/and I have coverage through his employer, but my children do not. Do I have to apply for MAGI for the entire household?
If your household’s income is less than 138%, you and your husband may have potential MAGI Medicaid eligibility. If that is your situation, you would have the option to disenroll from your employer sponsored healthcare and enroll in MAGI Medicaid. You can also keep yourselves on the employer sponsored health insurance and apply only for MAGI Medicaid for your children.