How Health Benefits Work

Disability-Based Medicaid

Look at disability-based Medicaid if:

  • You don't qualify for Medicaid in any other way
  • You don't qualify for SSI
  • You are a U.S. citizen or eligible immigrant
  • You have a disability
  • You have low resources, and
  • You have low income.

Disability-Based Medicaid if you don't get SSI

Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

If you have a disability and don't get SSI benefits, you may also qualify for disability-based Medicaid if you:

For disability-based Medicaid, you must meet all of these conditions. If so, you should probably apply for SSI, because that way you'll get monthly SSI payments and get Medicaid coverage. However, if you aren't getting SSI benefits and need medical coverage now, you can apply for disability-based Medicaid:

For help with your application, visit or call your local County Department of Job and Family Services (CDJFS) office or call the Ohio Medicaid Consumer Hotline at 1-800-324-8680 or 1-800-292-3572 (TTY).

Note: If you have Medicare coverage and don't qualify for Medicaid, you may qualify for a Medicare Premium Assistance Program (MPAP), which would help pay for your Medicare expenses. Learn more about MPAPs.

Reasons you might get disability-based Medicaid, but not SSI

SSI and disability-based Medicaid have nearly identical eligibility rules, but there are some differences. Here are a few examples of why you might get disability-based Medicaid, but not SSI:

  • You don't want to get SSI benefits.
  • You have a trust that helps you qualify for Medicaid, but not for SSI.
  • You have more than $100,000 in an ABLE account.
  • You have severe and persistent mental illness (SPMI).

If you have a disability, don't qualify for SSI, and need help from Medicaid, talk to a benefits planner to see if you might qualify for disability-based Medicaid or MBIWD.

Staying on Medicaid

Usually, once you are approved for Medicaid, you will continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your County Department of Job and Family Services (CDJFS) office know or report the changes online. When you report your changes, the county will tell you whether you will continue getting Medicaid or if you have new health coverage options, like individual coverage with subsidies or MBIWD.

Changes on August 1, 2016

There were major changes to these rules on August 1, 2016. Some of the changes include:

  • Anybody who gets SSI now gets Medicaid automatically.
  • Disability-based Medicaid now has higher income and resources limits, matching SSI's limits.
  • There is only one disability determination for SSI and Medicaid.
  • There is no more Medicaid spenddown. If your countable income is over the disability-based Medicaid limit, you may qualify for income-based Medicaid, MBIWD, an MPAP, or individual coverage with a subsidy.

For people who were already getting Medicaid coverage before August 1, 2016, these changes are being phased in over time. Learn more about the changes.

Learn more