Solution Announced For Medicaid Applications Stuck in Marketplace Website

By: Cathy Levine, Executive Director, UHCAN Ohio

Ohio officials announced this week that they had worked out an arrangement with the federal government to receive 106,000 applications from Ohioans who applied through the federal Marketplace and need to be transferred to Ohio Medicaid for eligibility determination. This comes as promising news, especially for people who may be waiting for health coverage.

The applications in question applied to the Marketplace and were found to be eligible for Medicaid. Planned as a “One-Stop Shop,” the Marketplace should have transferred the applications electronically to Ohio for Medicaid determination, but the electronic transfer “portal” isn’t working.

The federal government offered to send Ohio files with incomplete   information about the applicants, but the state declined on grounds that it could not effectively use the incomplete and allegedly error-ridden files After substantial back and forth about how to handle the situation, the state has agreed to accept the files and has worked out a system for processing them. First, a team will perform an initial evaluation to sort out duplicate applications. The remaining files will be sent to the counties for eligibility determinations.

Sorting through 106,000 files will be laborious and the bulk of the work will fall on county job and family services offices (JFS). But counties receiving fewer files have agreed to help counties with more files.

WHAT APPLICANTS NEED TO KNOW: If you applied through the federal Marketplace and were told you are eligible for Medicaid:

  • File an application for Medicaid in 1 of these 3 ways: go to www.benefits.ohio.gov, call the Ohio Medicaid Consumer Hotline at 800-324-8680, or go to your local Job and Family Services office. You should receive a decision in 30 days.
  • If you are found eligible for Medicaid, it will date back to the date you filed your original application. Therefore, if you incurred medical expenses after you filed your federal Marketplace application and after January 1st (for the expansion Medicaid population), they will be covered.
  • If Ohio finds that you are not eligible for Medicaid and have to return to the Marketplace, seek assistance from a Navigator or Certified Application Counselor and try to get your application resolved before the March 31 Marketplace deadline.

If you are confused, call us at 614-456-0060 x228