Ohio’s Changes to Medicaid Laws


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Medicaid Changes:  Ohio’s Transition to a 1634 State

As the Medicaid Eligibility Manual Transmittal Letter number 116 provides- Ohio transitioned from being a 209 state to a 1634 state for Medicaid eligibility. The transition impacted how Medicaid eligibility is determined for aged, blind, or disabled individuals. Most of the eligibility requirements are now based on criteria established by the Social Security administration for Supplemental Security income. As a 209(b) state, Ohio used eligibility criteria more restrictive than the SSI program for Medicaid determinations and provided a mechanism for individuals to reduce their income to the income eligibility level through the use of Medicaid spend down.

As a 1634 state, Ohio will now use SSA’s determination of an individual’s eligibility for SSI benefits as a determination for Medicaid coverage. Ohio has also chosen the option to determine eligibility for Medicaid coverage for individuals who do not receive SSI benefits but have a disability determination and meet the income and resource criterion for SSI. As a result of these changes, the Ohio Department of Medicaid reviewed all existing eligibility rules on aged, blind, or disabled Medicaid. Some rules were significantly rewritten, while others were simply updated.

The entire body of Letter number 116 can be read by clicking here.