Medicaid Eligibility

Medicaid helps people with low income pay for their visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services.

If you get Supplemental Security Income (SSI) benefits or used to get SSI benefits and now qualify for SSI's 1619(b) status, you get Medicaid coverage automatically and do not need to worry about the eligibility information discussed here.

If not, you may qualify for income-based Medicaid. The income-based Medicaid eligibility rules depend on whether you are:

You can apply for 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).

Medicaid if You Are 18 or Younger

If you are 18 or younger, you may qualify for income-based Medicaid if your family’s income is 211% of the Federal Poverty Guidelines (FPG) or less ($54,333 per year or less for a family of four). It doesn't matter how much your family has in resources or whether you have a disability. Note: Income-based Medicaid for children 18 and younger is sometimes called "Healthy Start."

Check whether your family's income is low enough for you to get income-based Medicaid:

Health Coverage Income Limits for Your Family

Note: Some young people with disabilities who don't get SSI and don't qualify for income-based Medicaid may still qualify for disability-based Medicaid. If you have any questions about this, talk to a benefits planner.

Is the child income limit for income-based Medicaid 206% or 211% of FPG?

You may see the children's income limit for income-based Medicaid listed as 206% of the Federal Poverty Guidelines (FPG). However, when Medicaid counts your income, they’ll knock 5% of FPG off your household income if you make more than 206% of FPG. That's why we say that you can make up to 211% of FPG, because it more accurately shows how much income you could have and still get Medicaid if you are under 19.

Medicaid if You Are 19 or Older

If you are 19 or older, you may qualify for income-based Medicaid if your family’s income is 138% of FPG or less ($17,236 per year or less if you are single). If you are pregnant, you can have income up to 205% FPG ($34,666 per year if you are single and pregnant with your first child; the baby counts as a family member according to Medicaid). It doesn't matter how much your family has in resources or whether you have a disability.

Check whether your income is low enough for you to get income-based Medicaid:

Health Coverage Income Limits for Your Family

If you have a disability, don't get SSI, and make too much for income-based Medicaid, you may qualify for disability-based Medicaid or for MBIWD.

Is the adult income limit for income-based Medicaid 133% or 138% of FPG?

You may see the income limit for income-based Medicaid listed as 133% of the Federal Poverty Guidelines (FPG) in some places. However, when Medicaid counts your income, they’ll knock 5% of FPG off your income if you make more than 133% of FPG. That's why we say that you can make up to 138% of FPG, because it more accurately shows how much income you could have and still get Medicaid. For pregnant women, this means we show 205% of FPG as the limit, rather than 200%.

Learn more about income-based Medicaid for adults in DB101's How Health Benefits Work article.

Individual plans on Healthcare.gov

If you don’t qualify for Medicaid or MBIWD, look into other health coverage options on Healthcare.gov. Learn more about private health insurance.