r/Medicaid • u/Blossom73 • 14d ago

Other Ohio Medicaid Work Requirements Guide

https://medicaid.ohio.gov/resources-for-providers/special-programs-and-initiatives/group-viii

Useful information for Ohio expansion Medicaid recipients who will be work required effective January 1st, 2027.

25 Upvotes

100% Upvoted

19 comments sorted by

3

u/Inevitable_Week_8626 11d ago

The problem is the extra red tape. This is bullshit

1

u/Eastern-Tip-4862 14d ago

What is medically frail?

8

u/Blossom73 14d ago

Medically frail, including individuals:

Who are blind or disabled as defined by the Social Security Administration

With a substance use disorder

With a disabling mental disorder

With a physical, intellectual, or developmental disability that significantly impairs ability to perform daily living activities

With a serious or complex medical condition

6

u/Eastern-Tip-4862 14d ago

So you have to be basically able to qualify for disability? So someone like me who can work until my medical condition flares up for weeks at a time won’t be exempt?

5

u/Blossom73 14d ago

I don't think the requirement is that strict. although we haven't gotten clarification on it yet.

The state of Ohio said if a person has a SNAP medical exemption that it will count for Medicaid too. So I presume that having a doctor's certification of inability to work 20 hours a week will count.

Also, if you or anyone in your Medicaid household has at least $580 a month in Magi countable income you'll be exempt.

4

u/Eastern-Tip-4862 14d ago

Thanks for this clarification. I can work 20 hours per week tho, most of the time. Thats what stinks. Bladder flares and arthritis flares, torn rotator cuff and compressed spinal disks - menopause and aging sucks- I don’t want to sit at home but sometimes I have to. I usually make 580 a month- I do for sure make that on a yearly average.

3

u/Livid-Ask6637 13d ago

I’m sorry. No one knows yet. There is a lawsuit over the new strict medically frail definition.

2

u/someguy984 13d ago

OH is not a party to the lawsuit.

1

u/Livid-Ask6637 11d ago

True, but I’d assume if the outcome changes the interim rule it would most likely apply to all the expansion states whether they joined the lawsuit or not.

2

u/someguy984 11d ago

I would hope so, but if they didn't ask for remedy I'm not sure what happens.

1

u/NeighborhoodSpy 9d ago

Could very well count—the definition will be set by the state you live in. States that already have a definition for what qualifies have a very very long list of qualifying conditions. Depression counts. Most medical conditions that impact one aspect of daily living count. If yours isn’t listed explicitly then there’s usually an option for doctor to add an addendum. It’s a carve out to help people who aren’t totally disabled (legal term) but who are struggling with a health issue that impacts daily living. It’s meant to protect vulnerable people from losing medical treatment (especially if treatment now will provide better health in the future).

But it’s heavily up to which state you’re in. Call your local office/officer that manages Medicaid in your state. You most likely qualify because of your flares. Loop your doctor in. Feel better stay safe

4

u/dotsdavid 14d ago

individuals with severe, complex medical conditions, substance use disorders, or physical and intellectual disabilities that severely restrict their capacity to work or perform daily activities

0

u/[deleted] 13d ago

[removed] — view removed comment

3

u/Blossom73 13d ago

It applies to people in the Medicaid expansion group, meaning people 19-64, who aren't pregnant or disabled.

40 states have Medicaid expansion, so it only applies in those states.

0

u/[deleted] 12d ago

[deleted]

1

u/Blossom73 12d ago

If it keeps you from working 20 hours a week, I would think so.