Lesson 01: Medicaid Covered Services
Getting Care
Ohio Medicaid offers its consumers four different options for getting health care services. Access to these services depends mainly on a consumer`s Medicaid eligibility category and/or care needs.
Traditional Medicaid (Fee-For-Service)
Ohio Medicaid has a network of providers statewide including (but not limited to): hospitals, family practice doctors, pharmacies and durable medical equipment companies. These providers bill Medicaid directly for health care services they provide to Medicaid consumers. Medicaid consumers eligible for getting care through Traditional Medicaid may go to any Ohio Medicaid provider who accepts Medicaid patients. Consumers should ask the provider if they accept Medicaid before scheduling an appointment. For a list of Ohio Medicaid providers, please contact the Consumer Hotline at 1-800-324-8680 or TDD/TTY 1-800-292-3572.
Medicaid Managed Care
In Ohio, certain Medicaid consumers get their health care services through managed care plans (MCP). MCPs are private health insurance companies responsible for arranging health care services for its covered members. MCPs provide all of the services offered through Traditional Medicaid but additional services may be provided by an MCP. Managed care providers bill MCPs directly for health care services obtained by their members. More...
Home and Community-Based Services
Home and community-based services programs provide alternatives to living in facility-based care settings (such as a nursing home or intermediate care facility). These programs are called "waviers" and allow for consumers to have an active role in their health care and to remain in the community. Waivers serve people who are elderly, who have mental retardation and/or developmental disabilites, and who have physical disabilities. More...
Facility-Based Care
Consumers who cannot care for themselves at home may need care in a facility-based care setting (such as a nursing home or other long-term care setting). Because this type of care can be costly, Ohio`s Medicaid program can help Medicaid-eligible Ohioans pay for their long-term care. More...