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How to apply for Medicaid coverage

Step One Please choose which Ohio Medicaid program you would like to apply for and complete the application.
Step Two Read the application carefully. Attach copies of your income, resources (see examples below), proof of citizenship or qualified-alien status, pregnancy (if applicable) and other insurance you may have. If you are applying because you are age 65 or older or disabled, you will need to provide proof of your age or disability as well.
Step Three Sign and date the application and send the application and any additional materials to us at this address:

     Washington County DJFS
          1115 Gilman Avenue
          Marietta, OH 45750

You may also fax it to us at (740) 373-9771, drop the application off at our agency or you may have an authorized representative apply on your behalf.

You can also go to ODJFSBenefits.Ohio.gov and click on the "Apply for Benefits" section to apply online.

Application

Use
Healthy Start & Healthy Families
(JFS 07216)

*Resources do not count
  • Medicaid for children, pregnant women and families.
  • This is also an application for WIC services, Child and Family Health Services and to get assistance through the Bureau for Children with Medical Handicaps.
Cash, Medical and Food Stamps
(JFS 07200)

*Resources do count
**Interview Required
  • Medicaid for adults 65 or older or people who are blind or disabled
  • This is also an application for cash, medical and/or food stamp assistance for all individuals
  • This application is also used for Disability Medical Assistance and Refugee Medical Assistance programs.
Help with Medicare Expenses
(JFS 07103)

*Resources do count
  • For people who have Medicare and limited income. This program helps pay for Medicare premiums, coinsurance and deductibles.
Request for Medicaid Home & Community-Based Services
(JFS 02399)

*Resources do count
**Interview Required

Please note: You must apply for Medicaid to receive waiver services.

Medicaid Buy-In for Workers with Disabilities Addendum
(JFS 07211)

*Resources do count

*Examples of Resources: Vehicles, Dividends, Interest, Cash, Savings Accounts & Certificates, Checking Accounts, Trust Funds/Estate, Stocks & Bonds, Revocable/Irrevocable Burial Contracts, Individual Development Account, Tax Shelter Account, Cemetary Lots, IRA, Keogh Plan, Credit Union, Christmas Club, Mutual Funds, Property, Life Insurance, etc.

If you need help completing your application please call (740) 373-5513.

Copyright © 2008 Washington County Department of Job & Family Services
1115 Gilman Avenue  Marietta, OH 45750
Phone: (740) 373-5513    Fax: (740) 373-9771