Ohio Managed Medicaid
The site lists Aetna, AmeriHealth Caritas, CareSource, Molina, UnitedHealthcare, Anthem, Buckeye, Humana and BWC among its managed Medicaid / payer references.
Coverage & eligibility
Understand the coverage conversation before care begins.
Home health eligibility depends on the patient’s clinical situation, physician involvement, payer requirements and current network participation. Madison can help verify the next step.
Traditional Medicare
Home health can be covered when Medicare requirements are met.
Madison’s current website states that traditional Medicare can cover allowable home health charges for eligible patients, without a deductible, co-pay or cost sharing for covered home health services.
Medicare generally requires a qualifying skilled need and a homebound status. The current site explains homebound as having difficulty leaving the home because of illness or injury, special equipment needs or the assistance of another person.
Important: Coverage is patient-specific. Call Madison or the patient’s payer to verify current eligibility, authorization and plan requirements.
Verify current network participation before scheduling care
Plans listed by Madison
Payer and program categories shown on the existing website
The current Madison website lists several Ohio Medicaid, MyCare and other program categories. These listings can change and should always be confirmed.
MyCare Ohio
The current accepted-plans graphic lists Aetna, CareSource, Molina, Buckeye and Anthem under MyCare Ohio.
Additional Programs
The site also references Passport and DODD. Call to confirm whether a patient’s specific program and location are currently served.
Before referral
Have these details ready when you call.
- Patient name and contact information
- Insurance or payer name and member details
- Ordering physician information
- Primary diagnosis and reason for home health
- Requested disciplines such as nursing or therapy
- Recent discharge or clinical documentation when applicable
Do not send protected health information through unsecured email or a general website form. Ask Madison for the approved referral process.
Need coverage verified for a referral?
Call Madison and ask what documentation and payer information are needed for the patient.