Ohio Code 5166.401 – Enrolllment for healthy Ohio program participants
A healthy Ohio program participant shall enroll in a comprehensive health plan offered by a managed care organization under contract with the department of medicaid. All of the following apply to the health plan:
Terms Used In Ohio Code 5166.401
- Contract: A legal written agreement that becomes binding when signed.
(A) It shall cover physician, hospital inpatient, hospital outpatient, pregnancy-related, mental health, pharmaceutical, laboratory, and other health care services the medicaid director determines necessary.
(B) It shall not begin to pay for any services it covers until the amount of the noncore portion of the participant’s buckeye account is zero.
(C) It shall require copayments for services covered by the health plan, except that a participant’s copayments shall be waived whenever the amount of the core portion of the participant’s buckeye account is zero.
(D) It shall have the following payout limits:
(1) Three hundred thousand dollars per year;
(2) One million dollars for a participant’s lifetime.