Parents & Families
Overview of Healthy Start and Healthy Families | Healthy Start is also known as Children's Medicaid/SCHIP | What Services are Covered? | Do my kids qualify? | Do I qualify? | Healthy Start I: Income/Eligibility requirements | Healthy Start II: Income/Eligibility requirements | Healthy Families: Income/Eligibility requirements | How do I enroll? | Documents required to apply | Where do I go to get an application and apply? | Who to contact | What to expect after you've submitted your application | Managed Care Plan Selection | Contact Us
Overview of Healthy Start
- Healthy Start is a Medicaid program designed for working families.
- Healthy Start provides free and low-cost health coverage to children and pregnant women who
meet certain age and income guidelines. - Healthy Start covers children and pregnant women up to 200% of the federal poverty level.
- Healthy Families provides free and low-cost health coverage to parents/caregivers and their dependent children who have income at or below 90% of the federal poverty level.
- Healthy Families provides the same quality health coverage as Healthy Start
Healthy Start is also known as Children’s Medicaid/SCHIP
- Programs designed to reach uninsured/underinsured families in Ohio were previously known as Children’s Medicaid or as the State Children’s Health Insurance Program (SCHIP). You may still hear those terms used. These programs are now incorporated under the program called Healthy Start.
- Depending upon your family’s income, you may be eligible for either Healthy Start I or Healthy Start II. See Income/Eligibility Requirements below for specific guidelines.
What services are covered?
- Doctor Visits
- Regular Check-Ups
- School and Sports Physicals
- Immunizations
- Substance Abuse Services
- Mental Health Services
- Vision (including eyeglasses)
- Dental Care
- Prescriptions
- Hospital Care
- Specialists and Early Periodic Screening Diagnostic and Treatment (EPSDT).
Do my kids qualify?
- Healthy Start is for children up to the age of 19, and pregnant women
- No legal custody is necessary
- Certain legal immigrants are included
- Healthy Start is an income-based program (see Income/Eligibility Requirements below).
Do I qualify?
- Healthy Families is for parents/caregivers and their dependent children
- You can have other health insurance and still qualify
- Healthy Families is an income-based program (see Income/Eligibility Requirements below).
Healthy Start I: Income / Eligibility Requirements
- Healthy Start I is for children up to 19 years of age.
- Household income must be between 0% and 150% of federal poverty guidelines.
- There is no premium cost to the family.
- Children in Healthy Start I can have other health insurance and still qualify.
- Click on this link to go to the most recent federal poverty guidelines by family size: http://jfs.ohio.gov/OHP/bcps/Fact Sheets/hshf.pdf
- NOTE: If your income is slightly above the 150% limit, you should still apply for Healthy Start I; you may be eligible for deductions that will bring you below 150%.
Healthy Start II: Income / Eligibility Requirements
- Healthy Start II is for children up to age 19.
- Household income must be between 151% and 200% of federal poverty guidelines.
- This program is for uninsured children.
- There is no premium cost to the family.
- Click on this link to go to the most recent federal poverty guidelines by family size: http://jfs.ohio.gov/OHP/bcps/Fact Sheets/hshf.pdf
- NOTE: If your income is slightly above the 200% limit, you should still apply for Healthy Start II; you may be eligible for deductions that will bring you below 200%.
Healthy Families: Income / Eligibility Requirements
- Healthy Families is for children up to age 19 and their parents/caregivers.
- Household income must be at or below 90% of the federal poverty level.
- There is no premium cost to the family.
- Children and parents/caregivers in Healthy Families can have other health insurance and still qualify.
- Click on this link to go to the most recent federal poverty guidelines by family size: http://jfs.ohio.gov/OHP/bcps/Fact Sheets/hshf.pdf
- NOTE: If your income is slightly above the 90% limit, you should still apply for Healthy Families; you may be eligible for deductions that will bring you below 90%.
How do I enroll?
Step 1: Apply
- Complete an application (see “Where do I get an application and apply?”, below)
- The application is part of a booklet entitled “Healthy Start/Healthy Families”
- It is called a Combined Programs Application (CPA) because it is also used to apply for WIC and BCMH. These programs are described on the first page of the application booklet.
- It is NOT necessary to complete the WIC and BCMH sections if you are applying only for Healthy Start/Healthy Families.
- You only need to complete one application for the family (not one for each person applying).
- No face-to-face interview is required if you are applying ONLY for Healthy Start/Healthy Families.
You may apply directly to the County Department of Job and Family Services, or you may request help with the application process by using the free services of the Ohio Benefit Bank, the Medicaid Consumer Hotline, or other social services agencies in your community (see “Where do I go to get an application and apply?”, below, for contact information).
Citizenship Documentation: All individuals applying for Medicaid must provide one-time documentation of their U.S. citizenship. Documentation is required only on the individual for whom you are applying for Medicaid coverage. You will be required to submit documentation of your identity, as well as separate documentation on place of birth and nationality. If you need help in obtaining these documents, you should ask the caseworker at the County Department of Job and Family Services for assistance.
Click here for a handy guide to the types of documents that can be used to meet the citizenship documentation requirements: http://jfs.ohio.gov/OHP/bcps/FactSheets/Citizenship.pdf
All documents must be originals or a copy that is certified by the issuing agency.
Social Security Number (only for children and any adults for whom you are applying for benefits)
Income the past 30 days (both earned and unearned):
- Earned income: Paycheck stubs for the past 4 weeks or letter from employer stating income and dates of employment.
- Self-employed: Copy of last year’s tax return, current business records and name and telephone number of bookkeeper.
- Child support: Amount and copy of court order or case number
- Income from rental property, unemployment compensation, disability income, social security income: official letter stating benefit or copy of recent check
If applicable, families must provide documentation of the following:
- Health Insurance Card (copy of front and back)
- Proof of pregnancy (if pregnant): Document signed by doctor or nurse with expected date of delivery and number of births expected
- Child care expenses for last 30 days: This may be a statement from the provider stating how much the parent pays for child care per month.
- Proof of Immigration Status if not a citizen: One of the following must be provided for non-U.S. citizen applications: INS I-94, I-95, I-51, I-551, INS I-688, or alien registration card
Step 2: Submit application with documentation
Follow these easy steps and check each step after you complete it:
- Make a copy of the completed application and documentation for your own files
- Place the Healthy Start Application booklet and copies of the required documentation in an envelope addressed to the County Department of Job and Family Services. (http://jfs.ohio.gov/county/cntydir.stm#25)
- Send the application to the County Department of Job and Family Services
- Methods of Submission Include
- Personal Delivery to County Department of Job and Family Services office (ask for a time stamped receipt for materials delivered)
- Mail (United States Postal Service, or other mail delivery company)
- Fax
Where do I go to get an application and apply?
- Ohio Benefits Bank
- Local social service agencies
- County Department of Job and Family Services http://jfs.ohio.gov/county/cntydir.stm#25
- Medicaid Consumer Hotline
- 1-800-324-8680/800-292-3572
- Program Information
- Application Assistance
- Blank Applications
- Web site – jfs.ohio.gov/ohp
Who to Contact
| Outreach & Enrollment Tool Kit | jfs.ohio.gov/ohp/tao/toolkit.stm |
| State Consumer Hotline | 1-800-324-8680 |
| Healthy Start Healthy Families website | www.state.oh.us/odjfs/ohp/bcps.stm |
| Enrollment Information Center | 1-800-360-3355 |
| Ohio State Legal Services Association | 1-800-589-5888; www.oslsa.org |
| Voices For Ohio's Children | 1-877-881-7860; www.vfc-oh.org |
| Ohio Benefits Bank | 1-800-648-1146; www.obb.ohio.gov |
What to expect after you’ve submitted your application
Once you’ve submitted your application to the County Department of Job and Family Services, it is important that you follow up to ensure you become enrolled in Healthy Start or Healthy Families.
This is what happens to your application when it arrives at a County Department of Job and Family Services:
- The application is screened through the County computer system to determine if the application or someone else in the household is already receiving benefits from the County
- If YES: The application is sent to the household’s present caseworker to determine eligibility for Healthy Start or Healthy Families
- If NO: The application is sent to a newly assigned caseworker
- The caseworker will send a notice to you confirming that your application was received at the County and advising you of his or her caseworker’s name and phone number.
- If more information is needed to process the application, the caseworker will send you a written request for the additional information and/or documentation.
- The caseworker will determine eligibility for Healthy Start or Healthy Families within 30 days of the date that you have submitted a complete application, including all requested documentation, and will send you a written notification of that determination within 45 days of the date the complete application and all requested documentation were received.
- If you are determined to be eligible, you will receive information on selecting a Managed Care Plan that will provide your health coverage.
- If you are determined to be eligible, the effective date of coverage will start on the date that your application was received. Under some circumstances it can go back as far as 90 calendar days prior to your date of application. If you have medical bills for services provided in the 90 days prior to your Healthy Start/Healthy Families application, talk to the case manager about whether your application can be made effective for a date prior to the date of application.
Over the Phone: Selecting a Plan over the phone is probably the easiest way to enroll. You will call Automated Health Systems (AHS). AHS is the vendor selected by the Ohio Medicaid program to help you select and enroll in a managed care plan once you have been determined eligible for Healthy Start/Healthy Families. Just call (toll-free) 1-800-605-3040 and ask to speak to a Selection Counselor. Be sure to have your Medicaid card(s) or your recipient number(s) handy. Selection Counselors will give you all the information you need and help you through the entire process.
In Person: If you would be more comfortable speaking to someone in person, Automated Health Systems has Selection Counselors located throughout the State. To schedule an appointment with one of them, simply call the toll-free number 1-800-605-3040 and ask to speak to a Selection Counselor (who will help you schedule an in-person appointment). OR see your local Field Selection Counselor's monthly calendar (located at your county department of job and family services building) to learn when a Field Selection Counselor will be on-site at that office.
Through the Mail: If you would like to read about the health plans available in your county and then mail in a completed selection form, just call the toll-free number 1-800-605-3040. Tell the Selection Counselor that you would like to receive a Selection Packet. They will send you one immediately, along with a postage paid envelope, so that you can mail in your Selection Form. OR you can download a selection form, print it from the web site, and mail in the completed form.
Contact Us
Voices for Ohio's Children877-881-7860
www.vfc-oh.org
Cleveland Office
3634 Euclid Avenue, Suite 101
Cleveland, OH 44115
216-881-7860
216-881-7863 [fax]
Columbus Office
614-510 E. Mound Street
Columbus, OH 43215
614-225-9073
614-228-5150 [fax]