The Ohio Department of Medicaid (ODM) has announced that they will begin eliminating spend-down after July 2016. People who are currently using health care expense spend-down to be eligible for Medicaid will have to meet income eligibility criteria (below 138% of the federal poverty limit, $16,242 per year for a single person; $24,250 per year for a family of four). At the same time, ODM will require only one determination of disability in order to qualify for Supplemental Social Security (SSI) and Medicaid benefits. Overall, this will bring a greater number of people into Medicaid but will also result in some people losing their Medicaid benefits.

If the following conditions apply to you, you may need to purchase insurance in the Health Insurance Marketplace:

• your income is over 138% of the federal poverty limit ($16,242 per year for a single person; $24,250 per year for a family of four);
• you do not have a disability determination; and
• you do not have persistent and severe mental illness.

 People losing their Medicaid benefits that are 65 or older may need to enroll in Medicare.

ODM describes these changes on their website. ODM will be sending information to all people affected in the next few weeks. It is important that you carefully review any information that you get from ODM.

UHCAN Ohio and our partners have encouraged Medicaid to make the transition as easy as possible for all who are impacted. This includes providing transition periods, expanding coverage to a broader range of behavioral health conditions, and effectively informing those impacted and giving them guidance. We are especially concerned about those who will be losing Medicaid coverage.

If you believe your income is above 138% FPL ($16,242 per year for a single person; $24,250 per year for a family of four) and you will lose Medicaid coverage as a result of the change to spend-down, please let us know how you will be impacted.

Send us an e-mail to tell us how this will impact you and if you are willing to be contacted. Knowing how this affects you will help us tell the Ohio Department of Medicaid how to improve the transition.

The changes that will occur after July 2016 are complicated and are very specific to each individual’s circumstances. It will be important that you pay attention to the letter that you get from ODM to know how you are affected and what you have to do. As more detail is available, we will share it with you. Sign up here to receive email alerts about Medicaid spend-down as they develop.