Key Facts
Medicaid in Ohio
Ohio expanded Medicaid in 2014, providing coverage to hundreds of thousands of previously uninsured adults. The expansion group, known as "Group VIII," provides comprehensive health benefits to eligible low-income Ohioans.
Who Qualifies for Ohio Medicaid?
- Adults ages 19-64 with income up to 138% FPL ($20,783/year for individuals) - Group VIII
- Pregnant women with income up to 200% FPL
- Children under 19 with income up to 206% FPL
- Seniors and people with disabilities meeting income requirements
- Parents/caretakers meeting income requirements
Ohio Medicaid Benefits
- Preventive care and wellness visits
- Doctor visits and specialist care
- Hospital inpatient and outpatient services
- Prescription drug coverage
- Mental health and substance abuse treatment
- Dental services (limited for adults)
- Vision care
- Laboratory and X-ray services
How to Apply
You can apply for Ohio Medicaid through:
- Online at benefits.ohio.gov
- By phone: 1-844-640-6446
- In person at your local County Department of Job and Family Services
- Through a certified application counselor or navigator
Health Insurance Marketplace
Ohio uses the federal Health Insurance Marketplace at HealthCare.gov. If you earn more than 138% FPL or prefer private coverage with more plan choices, the marketplace is your best option.
Available Plan Types
- Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
- Silver: Moderate premiums and costs (70% coverage) - best for subsidies
- Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
- Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)
Enrollment Periods
Open Enrollment: November 1, 2024 - January 15, 2025
Ohio Medicaid accepts applications year-round. You can also qualify for a Special Enrollment Period on the marketplace if you have a qualifying life event.
Average Costs in Ohio
Health insurance costs in Ohio vary based on your age, location, plan type, and tobacco use. Here are typical monthly premiums before subsidies:
| Plan Type | Individual (Age 40) | Family of 4 |
|---|---|---|
| Bronze | $340 - $410 | $1,100 - $1,350 |
| Silver | $430 - $530 | $1,350 - $1,700 |
| Gold | $500 - $600 | $1,550 - $1,950 |
| Ohio Medicaid | $0 | $0 |
Frequently Asked Questions
Has Ohio expanded Medicaid?
Yes, Ohio expanded Medicaid in 2014. Adults ages 19-64 earning up to 138% of the federal poverty level ($20,783 for an individual in 2025) qualify for Ohio Medicaid coverage through the Group VIII expansion.
What is Ohio Medicaid Group VIII?
Group VIII is Ohio's Medicaid expansion category for adults ages 19-64 with income up to 138% FPL. This group was created when Ohio expanded Medicaid in 2014. Members receive comprehensive health benefits through managed care plans.
When is Open Enrollment for Ohio health insurance?
Open Enrollment for 2025 marketplace coverage runs from November 1, 2024 through January 15, 2025. Ohio uses the federal marketplace at HealthCare.gov. Ohio Medicaid accepts applications year-round.
How much does health insurance cost in Ohio?
The average monthly premium for a benchmark Silver plan in Ohio is approximately $430-530 before subsidies. Many Ohio residents qualify for premium tax credits that significantly reduce costs, with some paying less than $100 per month after subsidies.
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