Ohio Medicaid Respite Care Benefit
Beginning January 2014, Ohio’s Medicaid program began offering a Respite Care benefit to assist families in caring for Medicaid eligible children under the age of 21 who have been determined eligible for Social Security Income for children with disabilities. Adults disabled since childhood who are under age 21 and receive Supplemental Security Disability Income are also eligible for respite if they also receive Medicaid.
Respite is available through Ohio’s five Medicaid Managed Care Plans (MCPs). Families interested in obtaining respite services must work with their health care provider to receive this benefit. If you already have a care manager from your health plan please reach out to them to help you.
What are Respite Services?
Respite provides short-term, temporary relief to support the caregiver. Respite provides for the general supervision, meal preparation, and hands-on assistance with personal care. Respite services can be obtained on a planned or emergency basis and shall only be furnished in the home. The provider must be awake during respite services and the services cannot be provided overnight.
Respite Benefit Eligibility Criteria
The Ohio Department of Medicaid has made rules for this benefit, including:
- Lives with his or her unpaid primary caregiver in a home or an apartment.
- Not in foster care
- Must be working with a Plan care manager
- Require skilled services at least once per week
- Have received at least 14 hours per week of home health aide services for at least six months before requesting respite services
Respite Benefit Coverage/Limitations
- Respite services are limited to no more than 24 hours per month and 250 hours per year
- Respite services must be provided by a qualified Medicaid provider
- Respite services cannot be delivered by the legally responsible family member/legal guardian or foster caregiver
- Prior authorization is required
Contact your Managed Care Plan
For more information about the new respite benefit, contact Paramount’s Case Management department, Toll Free: 1-800-462-3589 or Member Services at 1-800-462-3589, TTY users 1-888-740-5670.