New Medicaid Program Begins

Many Ohioans can now obtain health insurance beginning January 1, 2014, through the expanded Medicaid program.  In the past, one had to be disabled and have both limited income and assets to qualify for Medicaid.  The expanded program is entirely income-based; it removes the disability requirement, and disregards an individual’s assets.

To be eligible for coverage, one must:

  1. Be at least nineteen years old but less than sixty-five years old;
  2. Not be pregnant;
  3. Not be enrolled in or eligible for coverage under Medicare Part A or Part B;
  4. Have household income no more than 138% of the federal poverty level, using “MAGI” budgeting (see below); and,
  5. Not be eligible for coverage under another category of full Medicaid except for individuals with a “spend-down” (see below).

The 2014 federal poverty income level for a household of one person is $1,321/month.  Additional household members increase that amount by about $462 per person.  “MAGI” stands for “modified adjusted gross income.”  A person’s “adjusted gross income” is one’s federally taxable income as would be reported on Line 37 of IRS Form 1040, Line 21 of IRS Form 1040-A, or Line 6 of IRS Form 1040EZ.  That income is “adjusted” by adding back any tax-exempt interest or foreign investment income.

“Spend-down” Medicaid is available to those individuals whose incomes exceed the traditional needs standards – $632/month for an individual, and $1,082/month for a couple.  For example, if an individual’s income is $800/month, she can qualify for Medicaid after she spends down to $632 (i.e., spends $168) by paying medical bills.

Ohioans are now able to apply for the new Medicaid program online at or in person at the local County Department of Job & Family Services.  This health coverage will help a variety of categories of people including the working poor, and individuals who have lost their jobs but are not old enough to apply for Medicare.

Posted in Blog, Disabilities.