What You Need to Know About Transitional Medical Assistance in Ohio

If you or someone you know is in need of transitional medical assistance in Ohio, there are a few things you should know. Transitional Medical Assistance or TMA, is a program that provides temporary medical coverage for low-income adults who are transitioning from one public assistance program to another.

There are a few eligibility requirements for TMA, which include being a U.S. citizen or legal resident, being 18-64 years old, and having a gross income that does not

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What is Transitional Medical Assistance?

Transitional Medical Assistance also known as “spend-down medical assistance” is a program that provides health insurance coverage to low-income individuals and families who would not otherwise be eligible for full Medicaid benefits.

To be eligible for transitional Medical assistance an individual or family must have income below the Medicaid eligibility limit and must be “spending down” their income on medical expenses. Once an individual or family has spent down their income to the Medicaid eligibility limit, they will then qualify for full Medicaid benefits.

Transitional medical assistance can help families and individuals pay for a wide range of medical expenses, including doctor visits, hospital stays, prescription medications, and more. The amount of coverage and the specific benefits available will vary depending on each individual’s or family’s circumstances.

If you think you or your family may be eligible for transitional medical assistance in Ohio, contact your local county Department of Job and Family Services office today.

What are the Eligibility Requirements for Transitional Medical Assistance?

In order to be eligible for Transitional Medical Assistance (TMA) in Ohio, you must:

-Have been receiving benefits under the Medicaid program for at least 3 months
-Be employed, or have a job offer, or be participating in an employment and training program
-Be between the ages of 18 and 65
-Have an annual income that does not exceed 200% of the federal poverty level
-Be a resident of Ohio
-Not be eligible for any other form of medical assistance, such as Medicare

How Long Does Transitional Medical Assistance Coverage Last?

When you lose eligibility for Medicaid in Ohio, you may be able to stay on Medicaid for a limited time through Transitional Medical Assistance (TMA). TMA is a federal program that gives states like Ohio the option to provide coverage for up to six months to people who would otherwise lose Medicaid eligibility.

To be eligible for TMA in Ohio, you must:
-Have been receiving Medicaid for at least three months before your eligibility ends;
-Have a income at or below poverty level; and
-Be taking part in an employment and training program approved by the Ohio Department of Job and Family Services.

If you are eligible for TMA, your coverage will last for up to six months. Once your TMA coverage has ended, you may be eligible for continued Medicaid coverage through the Aged, Blind, or Disabled program.

What Types of Medical Services are Covered Under Transitional Medical Assistance?

There are four types of medical services that are covered under Transitional Medical Assistance (TMA) in Ohio: inpatient hospital services, outpatient hospital services, physician services, and Home Health Care services. In addition, TMA also covers the cost of necessary medical supplies and equipment.

How do I Apply for Transitional Medical Assistance?

In order to apply for Transitional Medical Assistance (TMA), you must first be eligible for and have received benefits through either the Ohio Works First (OWF) program or the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps). You must also meet one of the following conditions:

-You are a pregnant woman with a child under the age of 19
-You are a parent or primary caretaker relative with a child under the age of 19
-You are a child under the age of 19 who is not included in your parent’s OWF or SNAP case

If you meet these criteria, you can apply for TMA by completing an application at your local county Department of Job and Family Services office.

What Happens if I am Denied Transitional Medical Assistance?

If you are denied Transitional Medical Assistance (TMA), you have the right to a fair hearing. You may request a hearing by writing to the Ohio Department of Job and Family Services (ODJFS), Office of Hearings and Appeals, P.O. Box 182703, Columbus, OH 43218-2703, or by calling (866) 296-3542.

What are the Appeal Rights for Transitional Medical Assistance?

If you are not satisfied with the determination made by the Ohio Department of Medicaid (ODM) on your eligibility for Transitional Medical Assistance (TMA), you have the right to appeal that decision. You can file an appeal by asking for a hearing within 90 days of the date on the notice ODM sends you about its determination.

How is Transitional Medical Assistance Funded?

Transitional Medical Assistance (TMA) is a joint federal-state program that helps low-income individuals and families who are transitioning from welfare to work. TMA pays for medical coverage for former welfare recipients for up to 12 months after they lose eligibility for Medicaid. In Ohio, TMA is known as the Health Insuring Corporation of Ohio (HICO).

TMA is funded jointly by the federal government and the state. The federal share of funding is 75 percent and the state share is 25 percent. TMA is funded through the Regular Tax Appropriation process.

What are the Criticisms of Transitional Medical Assistance?

There are several criticisms of transitional medical assistance, or TMA. One is that it creates a financial incentive for people to remain on public assistance rather than seek work. TMA also disproportionately benefits able-bodied adults without dependent children, which some argue is unfair to other groups who are more in need of assistance. Additionally, TMA can be difficult to administer and often results in long waitlists for benefits.

Is Transitional Medical Assistance Available in Other States?

In general, transitional medical assistance (TMA) is available in all states. However, each state has its own specific rules and regulations regarding TMA eligibility and coverage. As such, it is important to check with your state’s Medicaid office to see if you qualify for TMA before enrolling in any TMA-related program.