Providers

Overview of Healthy Start and Healthy Families

Healthy Start and Healthy Families are Medicaid programs 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 and Healthy Families are not “welfare” programs. Eligibility for health care coverage is not linked to cash assistance programs.

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). These programs are now incorporated under the program called Healthy Start.
Depending upon a family’s income, it 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).

What are the qualifications?

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).

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 household income is slightly above the 150% limit, families should still apply for Healthy Start I; they may be eligible for deductions that will bring them 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 household income is slightly above the 200% limit, families should still apply for Healthy Start II; they may be eligible for deductions that will bring them 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 household income is slightly above the 90% limit, families should still apply for Healthy Families; they may be eligible for deductions that will bring them below 90%.

How do families enroll?

Step 1: Apply

Families must complete an application (see “Where can families 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 the application is only for Healthy Start/Healthy Families.
Only one application for the family needs to be completed (not one for each person applying).

No face-to-face interview is required applications is being made ONLY for Healthy Start/Healthy Families.

Applicants may apply directly to the County Department of Job and Family Services, or 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 the community (see “Where can families go to get an application and apply?” below for contact information).

Documents required to apply

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 one is applying for Medicaid coverage. Applicants will be required to submit documentation of their identity, as well as separate documentation on place of birth and nationality. A caseworker at the County Department of Job and Family can assist in obtaining these documents.

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 one is 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

Applicants should follow these easy steps and check each step after completing it:

Make a copy of the completed application and documentation for their 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 can families get an application and apply?

Ohio Benefits Bank

http://www.governor.ohio.gov/Default.aspx?alias=www.governor.ohio.gov/obb ; (800) 648-1176.

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 can families expect after submitting their application?

Once an application has been submitted to the County Department of Job and Family Services, it is important to follow up to ensure successful enrollment in Healthy Start or Healthy Families.

This is what happens to an 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 applicant 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 confirming that the application was received at the County and advising the applicant of his or her caseworker’s name and phone number.
If more information is needed to process the application, the caseworker will send 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 a complete application has been submitted, including all requested documentation, and will send a written notification of that determination within 45 days of the date the complete application and all requested documentation was received.
If an applicant is determined to be eligible, he or she will receive information on selecting a Managed Care Plan that will provide their health coverage.
If an applicant is determined to be eligible, the effective date of coverage will start on the date that the application was received. Under some circumstances it can go back as far as 90 calendar days prior to the date of application. If there are medical bills for services provided in the 90 days prior to the Healthy Start/Healthy Families application, an applicant should talk to the case manager about whether his or her application can be made effective for a date prior to the date of application.

Managed Care Plan Selection

Over the Phone: Selecting a Plan over the phone is probably the easiest way to enroll. The applicant can call Automated Health Systems (AHS). AHS is the vendor chosen by the Ohio Medicaid program to help applicants select and enroll in a managed care plan once they have been determined eligible for Healthy Start/Healthy Families. Applicants should call (toll-free) 1-800-605-3040 and ask to speak to a Selection Counselor. They should be sure to have their Medicaid card(s) or recipient number(s) handy. Selection Counselors will provide all the information needed to help applicants through the entire process.

In Person: Automated Health Systems has Selection Counselors located throughout the State for applicants who feel more comfortable speaking to someone in person. To schedule an appointment with one of them, applicants should call the toll-free number 1-800-605-3040 and ask to speak to a Selection Counselor (who will help schedule an in-person appointment). OR they may check their local Field Selection Counselor's monthly calendar (located at their county’s Department of Job & Family Services Building) to learn when a Field Selection Counselor will be on-site at that office.

Through the Mail: Those who would like to read about the health plans available in their county and then mail in a completed selection form can call the toll-free number 1-800-605-3040 and tell the Selection Counselor they would like to receive a Selection Packet. One will be sent immediately, along with a postage-paid envelope. OR they can download a selection form, print it from the web site, and mail in the completed form.

Contact Us

Voices for Ohio's Children
877-881-7860
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]