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Answer: If you make less than $16,104 per year (more for a family), you may qualify for Medicaid. To apply go to benefits.ohio.gov and complete an application.

 

If you make over $16,104 per year (more for a family), you can apply for insurance on the Healthcare marketplace. You may qualify for a subsidy that can help you pay for your monthly premiums. To apply go to healthcare.gov to complete an application.

Enrollment assistance in either Marketplace coverage or Medicaid is free and available in your community. Visit www.areyoucoveredohio.org to set up an appointment with a local enrollment assister or call the Ohio Association of Foodbanks at 1-800-648-1176.

Hospital Care Assurance Program (HCAP)

Patients who need hospital care, but are unable to pay for it, may be eligible for free or reduced fee care at Ohio hospitals through the Hospital Care Assurance Program (HCAP). Applications for HCAP are accepted by the hospital where care was received, and patients seeking HCAP assistance should contact their hospital’s billing department for application instructions. UHCAN Ohio DOES NOT accept HCAP applications.

To be eligible for HCAP:

  • You should be an Ohio resident.
  • You are not a recipient of the Medicaid program.
  • Your family income is at or below the current Federal Poverty Guidelines OR you are covered by the Disability Assistance Program.

 

See Ohio Administrative Code 5160-2-07.17

Prior hospital bills, paid or unpaid, may be covered by HCAP. Patients can apply for HCAP up to 3 years after the date of the first follow-up notice sent to a patient (not the date of service). Patients should contact the hospital’s billing department about prior bills and ask to apply for HCAP, even if the bill has already been sent to collections. If a patient already paid a bill but was eligible for HCAP, they may be reimbursed.

Hospital Financial Assistance Programs

For patients who do not qualify for HCAP, hospitals may have their own financial assistance programs. Since these programs are voluntary, each hospital has different rules and procedures. Call the hospital, ask for the financial assistance department, and ask about financial assistance options available for patients with incomes too high to qualify for HCAP.

Both HCAP and hospital financial assistance programs cover only hospital charges, not bills from non-hospital providers (such as x-rays, radiologists, and other medical providers who are not hospital staff members). However, many doctors may reduce or drop their fees when told that the patient qualified for HCAP. Patients should ask hospital billing departments to provide them with documentation stating they qualified for HCAP or other programs. The patient can then share this documentation with non-covered providers.

Prescription Assistance

Extra Help with Medicare Prescription Drug Plan Costs: Some Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia. Click here for more information or to apply online. The Ohio Benefit Bank offers help applying for this and other programs. Go to ohiobenefits.org or call 1-800-648-1176 for online or in-person application assistance.

 

Ohio’s Best Rx: Ohio’s Best Rx is a prescription discount card for ALL Ohioans of any age. Ohioans who are over age 60 or have incomes less than 300% of the Federal Poverty Level are eligible for additional savings. Discounts apply to almost all brand name and generic drugs. Ohio’s Best Rx is accepted at over 2,300 pharmacies in Ohio and 60,000 pharmacies nationwide, and there is also a mail order option. For more information or to sign up online, visit the Ohio’s Best Rx website. To enroll by phone, call 1-866-923-7879.

NeedyMeds: NeedyMeds is a 501(c)(3) national non-profit information resource dedicated to helping people locate assistance programs to help them afford their medications and other healthcare costs. Visit their website or call their helpline at 800-503-6897 for help finding prescription assistance.

Reduced Cost Pharmacy Programs: Many pharmacies offer savings programs or clubs that may provide discounts on certain prescriptions. Talk to your pharmacy to see if they offer a savings program.

Questions to ask my doctor or nurse

As of July 1, 2015, there are 666 Patient-Centered Medical Homes (PCMH) in Ohio. Many more primary care offices and clinics are working to become a PCMH. Here are some questions that you can ask your doctor or nurse to help receive the best care possible:

  • If yes: How will my care here be different from care in a medical office that is not a PCMH?
  • If no: Do you plan to become a PCMH?

Work as a team with the specialists that I see?

Make sure that I know all my treatment options and am the one that is in control of my health care?

Make it possible for me to communicate with you by e-mail?

Share my test results with me?

Help me create my health goals and understand what I need to do to meet them?

Provide screenings for things that may be wrong, such as depression, alcohol use, or drug use?

Send me reminders when I should schedule an appointment for yearly or other routine visits?

Can you provide resources for things I need to stay healthy, but can’t afford? For example, free or low-cost ways to exercise or stop smoking?

Can I get an appointment within 24 hours for urgent health needs?

Can I reach someone in the office by phone at night or on weekends?

If I have a chronic condition (e.g., diabetes), is there a system for tracking how I am doing?

Does the office team include non-physician staff members, such as nutritionists or nurse practitioners, to help me manage my medicines and chronic conditions?

Click here to print a copy of these questions:  Questions to ask my doctor or nurse 7 2015

Choosing Wisely has a fact sheet titled “5 Questions to Ask Your Doctor Before You Get Any Test, Treatment, or Procedure.”  Click here to view the fact sheet with questions.

Updated at Ohio Department of Health 7/20/2015

If you go to this link https://www.insurance.ohio.gov/Consumer/OCS/Documents/HowtoComplain.pdf, you will see the instructions for filing a complaint about your health insurance with the Ohio Department of Insurance. Read the several pages there and decide if you want to file your complaint electronically or by paper through the mail.  If you want to file your complaint electronically (on-line), use this link: https://gateway.insurance.ohio.gov/UI/ODI.CS.Public.UI/Complaint.mvc/DisplayConsumerComplaintForm

If you want to file your complaint by mail, call this number 1-800-686-1526 and ask for the paper complaint form to be mailed to you. Mail written complaints to:

The Ohio Department of Insurance
Consumer Services Division
50 West Town Street
Third Floor/Suite 300
Columbus, OH, 43215

Keep in mind that when you file a complaint, either by paper or electronically, your complaint may become a public record that the Department of Insurance would disclose to anyone asking for the complaints. We suggest if you have concerns about this that you call the complaint line 1-800-686-1526 and ask how the Ohio Department of Insurance will protect your confidential medical information or other personal information.

For consumers with questions about Medicare, the Department has an Ohio Senior Health Insurance Information Program (OSHIIP) offering support and advice to Medicare enrollees. To contact OSHIIP, call 1-800-686-1578 or email [email protected]  

Safety Net Dental Care Programs provide clinical dental services and generally are operated by local health departments, community health centers, hospitals, and other organizations that serve the community.  Safety Net Dental Care Programs offer sliding fee schedules, reduced fees, or free care to clients who can’t afford to pay a private dentist. http://www.odh.ohio.gov/~/media/ODH/ASSETS/Files/ohs/oral%20health/SN%20Brochure%2010_8_2015.pdf

Dental OPTIONS (Ohio Partnership To Improve Oral health through access to Needed Services) is a program offered by the Ohio Department of Health in partnership with the Ohio Dental Association. The mission of OPTIONS is to assist Ohioans with special health care needs and/or financial barriers to obtain dental care. OPTIONS patients are primarily adults; many are the “working poor” or elderly living on a fixed income. Eligible patients are matched with volunteer OPTIONS dentists who have agreed to reduce fees for dental care.

What you need to know about the OPTIONS Program

As a possible patient:

  • Dental OPTIONS is not an emergency program.
  • Only a few types of dental procedures are provided.
  • Fees are based on your income and certain health conditions. You must be able to pay some money at the time of each appointment. If you do not have any income or other money, you will not be able to apply.

If you think you might be eligible to apply, please call 1-888-765-6789 for more information about the program and how to apply

Office of the State Long-Term Care Ombudsman

1-800-282-1206

[email protected]

Or contact your regional ombudsman

Ohio’s Office of the State Long-term Care Ombudsman help people receiving home care, assisted living, and nursing home care select a provider and offer information about benefits and consumer rights.

In addition, ombudsmen:

  • Advocate for person-centered approaches by providers to meet the needs and honor the preferences of residents.
  • Link residents with services or agencies.
  • Offer resources for selecting long-term care providers.
  • Provide information and assistance with benefits and insurance.

How can I get help with my hospital bill?

Patients who need hospital care, but are unable to pay for it, may be eligible for free or reduced fee care at Ohio hospitals through the Hospital Care Assurance Program (HCAP). Applications for HCAP are accepted by the hospital where care was received, and patients seeking HCAP assistance should contact their hospital’s billing department for application instructions. UHCAN Ohio DOES NOT accept HCAP applications.

To be eligible for HCAP

  • You must be an Ohio resident.
  • You are not a recipient of the Medicaid program.
  • Your family income is at or below the current Federal Poverty Guidelines OR you are covered by the Disability Assistance Program.

See Ohio Administrative Code 5160-2-07.17

Prior hospital bills, paid or unpaid, may be covered by HCAP. Patients can apply for HCAP up to 3 years after the date of the first follow-up notice sent to a patient (not the date of service). Patients should contact the hospital’s billing department about prior bills and ask to apply for HCAP, even if the bill has already been sent to collections. If a patient already paid a bill but was eligible for HCAP, they may be reimbursed.

For patients who do not qualify for HCAP, hospitals may have their own financial assistance programs. Since these programs are voluntary, each hospital has different rules and procedures. Call the hospital, ask for the financial assistance department, and ask about financial assistance options available for patients with incomes too high to qualify for HCAP.

Both HCAP and hospital financial assistance programs cover only hospital charges, not bills from non-hospital providers (such as x-rays, radiologists, and other medical providers who are not hospital staff members). However, many doctors may reduce or drop their fees when told that the patient qualified for HCAP. Patients should ask hospital billing departments to provide them with documentation stating they qualified for HCAP or other programs. The patient can then share this documentation with non-covered providers.

Extra Help with Medicare Prescription Drug Plan Costs: Some Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia. Click here for more information or to apply online. The Ohio Benefit Bank offers help applying for this and other programs. Go to ohiobenefits.org or call 1-800-648-1176 for online or in-person application assistance.

Ohio’s Best Rx: Ohio’s Best Rx is a prescription discount card for ALL Ohioans of any age. Ohioans who are over age 60 or have incomes less than 300% of the Federal Poverty Level are eligible for additional savings. Discounts apply to almost all brand name and generic drugs. Ohio’s Best Rx is accepted at over 2,300 pharmacies in Ohio and 60,000 pharmacies nationwide, and there is also a mail order option. For more information or to sign up online, visit the Ohio’s Best Rx website. To enroll by phone, call 1-866-923-7879.

NeedyMeds: NeedyMeds is a 501(c)(3) national non-profit information resource dedicated to helping people locate assistance programs to help them afford their medications and other healthcare costs. Visit their website or call their helpline at 800-503-6897 for help finding prescription assistance.

Reduced Cost Pharmacy Programs: Many pharmacies offer savings programs or clubs that may provide discounts on certain prescriptions. Talk to your pharmacy to see if they offer a savings program.