01
Ohio Medicaid & managed care
Plan participation, benefits, prior authorization, and provider requirements vary by service and member.
Insurance and coverage
Coverage questions, made clearer.
The service, payer, authorization, provider participation, and individual plan all matter. Use this page to know what to verify—not as a coverage decision.
Four common pathways
Start with how the service may be funded.
The same person may have more than one program involved. Confirm every layer before services begin.
02
DODD & waiver programs
Services must align with eligibility, authorization, the individual service plan, and current waiver rules.
03
Medicare home health basics
Medicare has specific homebound, skilled-need, ordering, and participating-agency requirements. A&A does not promise Medicare coverage through this website.
04
Private pay & estimates
Ask the office about self-pay options and whether a written Good Faith Estimate applies to scheduled services.
Plans families ask about
Recognizable Ohio coverage pathways.
Plan and program names help identify a possible pathway—not guarantee participation, authorization, eligibility, payment, or availability.
- Ohio Medicaid programOhio Home Care Waiver Program
- Developmental disabilitiesOhio DODD Waiver Programs
Moving automatically. Hold and drag, swipe, or use the arrows to browse.
Always verify first. Call the member-services number on the insurance card and A&A at 216-230-9380. Ask about the exact service, location, authorization, network status, and expected out-of-pocket cost.
Before care begins
Ask for five clear answers.
Coverage is easier to navigate when the payer and agency are answering the same specific question.
- 01
Is this service a covered benefit for this member?
- 02
Is A&A eligible to provide and bill for this specific service?
- 03
Is a provider order, assessment, or prior authorization required?
- 04
What dates, frequency, units, or limits are authorized?
- 05
What cost, copay, or non-covered amount should be expected?
Official guidance
Use the payer or government source for current rules.
Let’s talk
Let’s make the coverage question specific.
Call with the plan name, service, location, and any authorization information you already have.
