Healthy Start is the State Children’s Health Insurance Program in Ohio, available to children whose family income exceeds the limits for Medicaid eligibility. In order to qualify for Healthy Start, children must be under age 19, and have total household earnings of no more than 200 percent of the federal poverty level (FPL). Pregnant women are also eligible for Healthy Start if their income is at or below 150 percent FPL.
Medicaid’s Healthy Start program has been in operation since 1989, serving pregnant women and children with public health insurance. The State Children’s Health Insurance Program (SCHIP) was formed in 1997 to cover a larger number of uninsured children. The state of Ohio administers their SCHIP program through Healthy Start, thus extending coverage to a greater amount of young residents. Therefore, Healthy Start is both a Medicaid and CHIP program.
To qualify for Healthy Start, children must meet the income guidelines according to their family size in relation to the federal poverty level. If the percentage of income is less than or equal to 200 percent of FPL for the number of individuals in the household, a child will usually be eligible for benefits through this program. Eligible children and pregnant women must also be residents of Ohio, and have citizenship in the United States or be a qualified alien.
Pregnant women of any age are eligible for the Healthy Start program for the whole duration of their pregnancy, and up to 60 days after giving birth. Infants who are born to mothers enrolled in the program are automatically eligible for free health insurance through Healthy Start from their date of birth through their first birthday. Healthy Start is also available to certain children under age 21 who are aging out of the foster care system.
Children in families whose income is between 150 and 200 percent of FPL must be considered uninsured in order to qualify for Healthy Start. Those who have a household income below 150 percent of FPL are allowed to have other health coverage and still be eligible for the program. Below is a chart of income guidelines for families up to 4 people, indicating the maximum amount the household can earn per month in order to receive Healthy Start coverage.
Medicaid and Healthy Start offer the same set of benefits, which includes the following medical, dental, and vision services. Most of these services will be available for free, though there is a copayment required at the time of service for certain types of care for higher income Healthy Start members. For those with higher incomes, copayments typically range from $3 to $5. Particular services are limited by dollar amount, number of visits offered throughout the year, or the facility in which they are provided.
- Ambulance and other emergency medical transportation
- Dental care (medical and surgical)
- Medical vision care, including eyeglasses
- Prescription medications
- Doctor’s office visits and physician services
- Occupational, physical, and speech therapy
- Inpatient hospital care
- Outpatient services, including care received at Rural Health Clinics and Federally Qualified Health Centers
- Home health care
- Family planning services and supplies
- Healthchek (EPSDT) program services
- Chiropractic care
- Durable Medical Equipment and supplies
- Independent psychological services for children
- Community substance abuse treatment
- Community mental health treatment
- Home and Community-Based Services Waivers
The Children’s Buy-In (CBI) Program
If your income is too high to qualify for Healthy Start, the Children’s Buy-In program is available to uninsured children in families that earn up to 300 percent of the federal poverty level. CBI is offered to working families with uninsured children who have special health needs or high monthly insurance premiums. In order to qualify, children must be uninsured for at least six months prior to enrollment and meet additional guidelines. Monthly premiums for each applicant will be determined according to income.
Healthy Start & Healthy Families
30 East Broad Street
Columbus, OH 43215