Ohio Medicaid work and community engagement requirements

Starting January 1, 2027, Medicaid eligibility will be changing for some members in Group VIII. 

Mom, infant and teen smiling in portrait

Due to new federal laws, Medicaid members eligible for and enrolled in Group VIII coverage (also known as MAGI Adult or Ribicoff coverage), are subject to a Work and Community Engagement Requirement. Most adults must work or participate in other approved activities at least 80 hours a month to keep Medicaid coverage. 

For more information regarding this change please visit the Ohio Department of Medicaid (ODM) Work and Community Engagement webpage opens in new window

Does this requirement/rule apply to me?

This rule may apply to some adults who:

  • Are age 19 to 64
  • Have Ohio Medicaid through Group VIII (may also be called MAGI Adult or Ribicoff coverage)
  • Have Medicaid because of their income
  • Do not meet an exemption

If you are not sure what Medicaid group you are in, you can:

Am I exempt from this rule? 

Some people may be exempt. This means they may not need to do work or activity hours to keep Medicaid.

You may be exempt if you are:

  • Under age 19
  • Over age 65
  • Pregnant or recently had a baby
  • Eligible for Medicare
  • Caring for a child age 13 or younger
  • Caring for a disabled person
  • Meeting SNAP or TANF work rules
  • Living with a disability or serious health condition
  • Taking part in a substance use treatment program
  • A former inmate of a public institution in the last 3 months
  • Native American or in another exempt group

ODM  will give more details about exemptions before the rule starts.

What activities may count towards work requirements? 

If the rule applies to you, you may need to do 80 hours each month of one or more activities.

These activities may include:

  • Working
  • Volunteering
  • Taking part in a work program
  • Going to school at least half time
  • Doing more than one of these activities for a total of 80 hours each month

ODM  will explain how to report your hours and what papers you may need.

Keep your information up to date

You must report changes within 10 days.

This includes changes to your:

  • Income
  • Job
  • Address
  • People in your home
  • Pregnancy status
  • Other life changes

This can help you avoid a gap in your Medicaid coverage.

You may get letters from your County Department of Job and Family Services. Read all letters right away. Send any papers they ask for by the due date.

Humana Healthy Horizons can help you prepare

Humana is here to help you learn about resources that may support your health, work and daily needs.

Humana may be able to help you with:

Contact Humana Member Services at 877-856-5702 (TTY: 711), Monday-Friday, 7 a.m-8 p.m., Eastern time, to ask what help may be available to you.

Starting January 1, 2027 Humana Workforce Development benefit in Ohio

Humana Healthy Horizons in Ohio offers a Workforce Development Program for eligible members.

Members age 18 and older who take part in Humana’s Workforce Development Program can get up to $200 for approved work needs.

This money may help pay for:

  • A job training certificate
  • A work license
  • Work clothing
  • Work gear

This benefit can help you get ready for work or job training.

To learn more, contact Humana Member Services at 877-856-5702 (TTY: 711), Monday-Friday, 7 a.m-8 p.m., Eastern time.

Questions? 

The State of Ohio will have the most current information about the new Medicaid work rule. 

You can: