Financial Assistance
Multiple financial assistance programs are available for the families of children with special needs, on a local, state and national level. All programs have financial eligibility requirements, and some have additional medical eligibility requirements. Please refer to the eligibility criteria for each program.
The Center for Infants and Children with Special Needs at Cincinnati Children's Hospital Medical Center provides information to help families and health care providers identify sources of financial assistance.
Food l Housing l Legal Services l Medicaid Waivers / Home Health Care Programs l Medicare Prescription Plan / Part D l Medical Assistance l Nutrition l Ohio Department of Job and Family Services l Prescription Assistance l Social Security l Utilities | Other
Find additional information about financial assistance resources in Indiana and Kentucky.
Food
- Freestore Foodbank provides food and clothing to people who are unemployed, whose homes have been destroyed by flood or fire or who are in need. They distribute donated and surplus food to approximately 500 non-profit agencies in 20 counties, who in turn help prevent hunger in their own neighborhoods.
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Housing
See Home Health Care for information and resources on home modifications which allow people with disabilities to live more independently in their own home.
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Legal Services
- Legal Aid Society of Greater Cincinnati mission is to resolve serious legal issues for for low-income individuals. Residents of Hamilton, Butler, Brown, Clermont, Clinton, Highland and Warren counties are served.
- Ohio Legal Rights Service serves people with developmental disabilities, mental illness, or other significant physical or mental impairment. They provide information and referral, representation and individual casework.
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Medicaid Waivers / Home Health Care Programs
Medicaid can pay for services to help an eligible individual with significant special needs continue to live at home through Waiver Programs and Home Health Care Programs. A key difference is that financial eligibility for a Waiver Program is based on the income of the individual while eligibility for the Home Health Care Program is based upon the income of the family.
Waiver Programs
A waiver is one way that Medicaid enables an individual with mental retardation, developmental disabilities or significant health care needs to live at home. While some eligibility requirements are "waived" for these programs, the individual must require a protective level of care related to daily living skills or skilled medical care. The financial criteria is based only on the income of the individual. Since waiver programs pay for services for a limited number of people, their openings can fill up quickly and there may be a waiting list. Children who have been hospitalized for more than 30 consecutive days will be given priority on the waiver waiting list, thereby significantly reducing their waiting time.
The following table is a brief overview of Waivers in Ohio. The Home and Community-Based Waivers Medicaid Fact Sheet provides a more detailed comparison of all Ohio waivers, including eligibility and application process information.
| Waiver | Eligibility | Services | Agency |
|---|
| Individual Options Waiver |
Mental Retardation / Developmental Disabilities, Skilled Level of Care, Financial Criteria, All Ages |
Respite, Supported Employment, Environmental Adaptations, Transportation, Specialized Medical Equipment, Homemaker / Personal Care, Social Work |
Ohio Dept. of Mental Retardation and Developmental Disabilities |
| Level One Waiver |
Mental Retardation / Developmental Disabilities, Skilled Level of Care, Financial Criteria, All Ages |
Respite, Environmental Adaptations, Transportation, Specialized Medical Equipment, Homemaker / Personal Care, Emergency Services |
Ohio Dept. of Mental Retardation and Developmental Disabilities |
| Ohio Home Care Waiver |
Skilled or Intermediate Level of Medical Care, Financial Criteria, All Ages |
Respite, Nursing, Daily Living Services, Therapy, Environmental Adaptations, Transportation, Adaptive Devices |
Ohio Dept. of Job and Family Services |
| Transitions Waiver |
Open only to Ohio Home Care Waiver recipients who have Mental Retardation / Developmental Disabilities, Skilled Level of Medical Care, Financial Criteria,
All Ages |
Respite, Nursing, Daily Living Services, Therapy, Environmental Adaptations, Transportation, Adaptive Devices |
Ohio Dept. of Job and Family Services |
| PASSPORT Waiver |
Skilled Level of Medical Care, Financial Criteria, Age 60+ |
Homemaker / Personal Care, Environmental Adaptations, Transportation, Medical and Adaptive Equipment, Social Work |
Ohio Dept. of Aging |
Medicaid Waiver Programs are administered through several Ohio agencies.
Centers for Medicare & Medicaid Services provides information on Medicare, Medicaid and Waiver programs throughout the United States.
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Home Health Care Programs
Ohio Medicaid's State Plan is administered by the Ohio Department of Job and Family Services, Bureau of Home and Community Services. Individuals must be eligible to receive Medicaid. Establishing medical need, through a physician, is one of the requirements prior to receiving services.
There are several benefit programs that can provide nursing, aide and / or skilled therapy services:
Home Health Services (State Plan), formerly known as CORE, provides a combination of part time, intermittent nursing, aide and / or skilled therapy services for up to 8 hours per day and 14 hours per week. Services must be prescribed by your physician and provided by a Medicare-certified home health agency. Medicare certified home health agencies can be located by state, county and zip code. Home Health Services can be increased under certain circumstances:
- Post Hospital Service for Home Health provides part time, intermittent services for up 60 consecutive days from the date of discharge from an inpatient hospital stay of 3 or more days. Nursing, aide and / or skilled therapy can be provided for up to 28 hours per week in visits of up to 4 hours each. Your physician must submit a Certificate of Medical Necessity. The individual must qualify for an institutional level of care and require skilled services at least once per week.
- Home Health Services HealthChek (State Plan) provides part time, intermittent services which can be increased up to 28 hours per week for more than 60 days for children who qualify for an institutional level of care and require skilled services at least once per week. The level of care must be determined by CareStar, the case management agency for the Ohio Department of Job and Family Services, Bureau of Home and Community Services.
Private Duty Nursing is available to individuals with an Ohio Medicaid card, who qualify for an institutional level of care due to a high need for medical support. It is designed for individuals requiring continuous skilled nursing, ranging from 4 to 12 hours per visit, for more than 56 hours per week and for longer than 60 days. Services must be prescribed by your physician and prior authorization must be received from the Ohio Department of Job and Family Services, Bureau of Home and Community Services, Services must be provided by a Medicare-certified home health agency, accredited home health agency, or non-agency RN / LRN. Medicare certified home health agencies can be located by state, county and zip code. - Post Hospital Service for Private Duty Nursing provides continuous services for up 60 consecutive days from the date of discharge from an inpatient hospital stay of 3 or more days. Nursing, aide and / or skilled therapy can be provided from 4 to 12 hours daily, up to 56 hours per week. Your physician must submit a Certificate of Medical Necessity. The individual must qualify for an institutional level of care and require skilled services at least once per week.
See Home Health Care for information and resources on home modifications which allow people with disabilities to live more independently in their own home.
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Medicare Prescription Plan / Part D
Medicare's new prescription drug coverage, sometimes called Medicare Part D, began January 1, 2006. You have a choice of prescription drug insurance plans which are available through private insurance companies. Participation is income driven, therefore you will pay a monthly insurance premium plus a portion of the prescription cost through a copayment.
Medicare prescription insurance plans are open to everyone who is eligible for Medicare. This includes individuals who are 65 years of age or older, or younger people who receive Social Security Disability Income (SSDI) or who have kidney failure. You have to choose a plan by May 15, 2006 to avoid a late enrollment fee. If you have enrolled but have not received your prescription card, present your Medicare card to the participating pharmacy with the last four numbers on your Social Security card.
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Medical Assistance
- Cincinnati Children's Financial and Medical Assistance Programs for Families has counselors who can help arrange for payment plans, discounts and financial assistance for eligible patients and families. The Hamilton County Tax Levy provides medical coverage for indigent care through the University of Cincinnati Hospital and Cincinnati Children's. For further information and an application, please contact Patient Financial Services at Cincinnati Children's, 513-636-4427.
- Bureau for Children with Medical Handicaps (BCMH) is a tax-supported, state-administered program through the Ohio Department of Health. The mission of BCMH is to assure that children under age 21, with special health care needs, obtain comprehensive medical care and services that are family centered and community based.
The publication is available in portable document format (.pdf). You must have Adobe Acrobat" Reader installed on your computer to read pdf files.
You can download Adobe Acrobat" Reader at Adobe's Web site by selecting the version appropriate for your type of computer.
- Children and Youth with Special Health Care Needs are supported in each state through Title V government funding. A directory of local contact information and services is available.
- EMTALA, the Emergency Medical Treatment and Active Labor Act, requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. Patients needing emergency treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment.
- Medicaid is a publicly funded health insurance program that provides health coverage to families with low incomes, children, pregnant women and people who are aged, blind or who have disabilities. Individuals must first apply for Social Security benefits (SSI / SSDI) prior to applying for Medicaid.
Institutional Medicaid may be available when a child resides in an institution (hospital or residential facility) for more than 30 days. The income and resources ot the child's parents are no longer counted in determining the Medicaid eligibility of the child. Therefore, children who are institutionalized for more than one month will generally qualify for Medicaid while they are in the hospital or residential facility. This coverage is only for care after the 30 days and is not retroactive to the first month. Once children are discharged, they no longer qualify for Institutional Medicaid and must then qualify based on the family's income or through a State Waiver Program.
Medicaid for the Aged, Blind or Disabled (ABD) in Ohio may require that adults who receive health care benefits join a Managed Care Plan (MCP), depending on their local county office. This means that certain private health insurance companies have an agreement with the Ohio Department of Job and Family Services to provide health care to individuals that receive Medicaid. Eligible consumers in the Southwest Ohio Region must select and enroll in an MCP. Additional information is available through the Ohio Department of Job and Family Services:
- Medicaid Buy-In for Workers with Disabilities (MBIWD) begins in Ohio on April 1, 2008. MBIWD is an Ohio Medicaid program that provides health care coverage to working individuals with disabilities. Historically, people with disabilities were often discouraged from working because their earnings made them ineligible for Medicaid coverage. MBIWD was created to enable Ohioans with disabilities to work and still keep their health care coverage. The program has eligibility and financial requirements. Applications are available from your local county office of Ohio Department of Job and Family Services.
- Medicaid will provide transportation in keeping with the child's medical needs. Transportation services can be provided though the use of bus tokens, cab service or medical transport. In Hamilton County, you must call five business days before your medical appointment to schedule a trip. You can confirm your ride by calling 513-587-4880 the day before your appointment. Transportation services are arranged by contacting the representative based on the first letter of the child's last name:
- M, N, O, P (513-946-1675)
- C, G, K, L (513-946-1640)
- B, E, F, Z (513-946-2027)
- H, I, R, U (513-946-1744)
- A, D, S, Q, V (513-946-1778)
- J, W, T, Y, X (513-946-1242)
- Medicaid contract providers in Hamilton County for stretcher transport are Medcorp (513-984-2000) and Rural Metro (513-863-5000). For wheelchair or stretcher transport the contract provider is Universal Transport (513-829-1287).
- Southwest Ohio Regional Transit Authority (SORTA) operates Access, a wheelchair accessible transportation service. This service must be applied for in advance.
- Medicare provides qualified adults with disabilities with publicly funded health insurance. This site provides general information about the Medicare program and has an online "eligibility tool."
- State Children's Health Insurance Program (SCHIP) is federally funded health insurance designed to provide support to families and children up to the age of 19.
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Nutrition
- Women, Infants, and Children (WIC) provides supplemental, nutritious foods for pregnant mothers, new mothers and children under five who are income eligible. Physician-prescribed formulas for children with medically based nutritional needs are also provided. Additionally, families can access an online, statewide Ohio WIC Main Clinics Directory.
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Ohio Department of Job and Family Services
Ohio Department of Job and Family Services provides a variety services and financial assistance programs that are summarized in their annual Program Guide. Some of these include:
- Child Care Subsidies are available for low-income working parents or parents participating in an approved employment or training program.
- Food Stamps assist eligible low-income individuals and families purchase food and food products. A brochure is also available online.
- Ohio Works First provides financial assistance to eligible individuals with an emphasis on self-sufficiency and employment.
- Temporary Assistance for Needy Families (TANF) provides funds to eligible families to support training, employment, short-term basic needs and disaster assistance.
- Applications for Ohio Job and Family Services financial assistance programs are available on their web site. You can also find a directory of county offices.
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Prescription Assistance
Financial assistance for prescription medications is available in many forms including copayment coupons, discounts and free medications for those who qualify financially. Please remember that your physician's office may be able to obtain samples of certain medications. Medicaid and the Bureau for Children with Medical Handicaps (BCMH) may also provide a prescription benefit. Additional assistance may be available through a Medicare prescription plan.
- Access to Benefits helps people find programs to save money on prescriptions.
- Free Medicine Program's mission is to help patients obtain prescription medications free of charge.
- GSK Patient Assistance Programs provides information on prescription savings programs for eligible individuals.
- Jungle Jim's in Fairfield, Ohio provides a reduced cost prescription drug plan for savings on selected generic medications.
- Kroger Pharmacy offers a $4 generic drug program on more than 300 medications.
- Lilly Cares provides prescription assistance to qualified patients through their physicians.
- The Medicine Program provides assistance to qualified patients for the purpose of obtaining prescription medication free-of-charge from available programs.
- Meijer Pharmacy is offering selected antibiotics free to anyone, regardless of insurance coverage.
- Merck offers a patient assistance program which provides its medicines free or at a discount to those who cannot afford them.
- NeedyMeds is a comprehensive listing of patient assistance programs that provide no cost prescription medication to eligible participants. You can find information organized by program, company and brand name as well as links to state resources, Medicaid information and articles on patient assistance programs.
- Ohio's Best Rx is a medication discount program for qualified individuals.
- Partnership for Prescription Assistance provides information on prescription drug savings and assistance programs.
- Prescription Relief is a prescription savings program for qualified individuals who do not have Medicaid or prescription drug coverage.
- RxAssist is designed to provide health care providers with information to access pharmaceutical manufacturers patient assistance programs.
- Rx For Ohio searches government, industry and privately sponsored programs for over 1,400 medications for patient assistance programs.
- Rx Outreach offers generic medications to qualified individuals.
- Together Rx Access is a prescription savings program for qualified individuals and families without prescription drug coverage.
- WalMart Pharmacy provides a $4 generic drug program with over 300 medications, available in participating states.
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Social Security
Social Security has two programs that provide assistance for adults with disabilities that are based only on the income of the individual. An online Benefit Eligibility Screening Tool is available to help you determine which programs would meet your needs. Children with disabilities may also qualify for these Social Security disability programs. A Child Disability Starter Kit and application information are available.
- Supplemental Security Income (SSI) is a federal income supplement program designed to help aged, blind and disabled people who have little or no income meet basic needs for food, shelter and clothing with a monthly cash payment. A child from birth to age 18 may be eligible to receive monthly payments based on disability or blindness.
- Social Security Disability Income (SSDI) is designed to help people with disabilities who have worked in jobs covered by Social Security. The program provides monthly cash benefits for food, shelter and clothing. An adult child, age 18 or older, may be eligible to receive monthly benefits based on disability or blindness.
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Utilities
- Cincinnati Bell Customer Support services has equipment and assistance for individuals with speech / hearing impairments, physical impairments and other special needs. You can contact their Special Needs Department at 513-565-4424 (voice only), 513-241-2899 (TDD/TTY) or 513-241-2942 (Fax).
- Cincinnati Bell Lifeline Program is a telephone assistance program offering monthly discounts to qualified customers in Ohio, Kentucky and Indiana. Program information and an application are provided.
- Lifeline Link-Up is a telephone discount program that gives people with low incomes a discount on basic monthly phone service. Information is available on individual state programs.
- HeatShare is a Duke Energy sponsored program in Ohio that is designed to assist those in need with heating bills during the winter season. WinterCare is available in Kentucky and Helping Hand is available in Indiana. Home weatherization service provides information on how to manage utility bills and reduce energy costs.
- Duke Energy's Life Support Program encourages customers with special electrical needs to register so they can be notified in advance about scheduled power outages. Duke Energy strongly urges customers to have either a backup power source or an alternative plan in the event of a power outage. Participation in the Life Support Program does not prevent disconnection, following notification, for non-payment of a bill.
- The United Way & Community Chest Information and Referral Services line at 211 (or in Ohio 513-721-7900 and in Kentucky at 859-525-2600) provides referrals to county-based utility assistance programs, as well as numerous other programs.
- Ohio Department of Development offers multiple energy assistance programs. This site allows an individual to apply for several federal and state programs in one online application. Programs described here include:
- Home Energy Assistance Program (HEAP)
- Emergency Home Energy Assistance Program (E-HEAP)
- Percentage of Income Payment Plan (PIPP)
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Other
- Aubrey Rose Foundation awards grants to eligible families to help pay outstanding medical bills that are not covered by insurance.
- Building Blocks Foundation has the goal of improving the well-being and quality of life for children whose parents cannot financially meet a particular medical need. Needs can range from a hearing aid to a wheelchair to life-saving surgery. Applications are available online.
- Challenged America has an online grant application to apply for products and services for children under age 18 who have physical challenges.
- Child Wellness Fair is a nonprofit health organization that connects families and healthcare professionals to identify and address community needs. Their Child Wellness Center provides information on a variety of health topics. Their If Only I Had A... program assists families with a variety of needs to help make the life of a child with medical needs easier. The Child Wellness Fair also operates a Vehicle Donation program to assist families and organizations. Their Second Home program facilitates the donation of medical equipment and supplies and helps connect families with needed resources.
- DisabilityInfo.gov is a comprehensive web site for assistance programs and disability-related resources available on federal, state and local levels.
- First Hand Foundation provides financial assistance for eligible children whose clinical, health care needs are not adequately covered by insurance and state aid.
- Freestore Foodbank in Cincinnati has an online Community Resource Directory.
- GovBenefits.gov connects users to federal, state and local government benefits and assistance programs. Users can find programs organized by state, by subject, or by answering a detailed online questionnaire. Comprehensive eligibility and agency contact information is provided.
- Hear Now Program, a division of the Starkey Hearing Foundation, offers assistance in acquiring hearing aids to those with limited financial resources.
- United Healthcare Children's Foundation offers assistance grants for children's medical services not fully covered by health insurance.
- The Wheelchair Foundation is an international nonprofit organization that assists children and adults with financial needs obtain wheelchairs. You can also subscribe to their free newsletter.
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If your questions are not fully answered by our Special Needs Resource Directory and its links, please contact us via email.
Rev. 6/08
