State Agencies | Online Services
 

How to Enroll

The Children with Medical Handicaps Program (BCMH) provides assistance to families who have children with special health care needs who meet the medical and financial eligibility criteria.  All criteria are for children under the age of 21 who have special health care needs and are residents of the State of Ohio.

In order to enroll in BCMH, a Medical Application Form  must be submitted by a BCMH-approved physicianLocal health department public health nurses can provide a referral to start the enrollment process.  Dependent upon the program, financial eligibility may or may not be a criteria.

Medical Eligibility Criteria

For the BCMH Diagnostic Program, a child must:

  • Be under the age of 21
  • Be a permanent resident of Ohio
  • Be under the care of a BCMH-approved doctor (MD or DO)
  • Have a possible special health care need

For the BCMH Treatment Program, a child must:

  • Be under the age of 21
  • Be a permanent resident of Ohio
  • Be under the care of a BCMH approved doctor (MD or DO)
  • Be financially eligible
  • Have an eligible special health care need

For the Service Coordination Program, a child must:

  • Be under the age of 21
  • Be a permanent resident of Ohio
  • Be under the care of a BCMH-approved hospital specialty team approved for service coordination
  • Have a diagnosis eligible for service coordination

Financial Eligibility Criteria

The BCMH Treatment Program has a financial eligibility requirement.

Financial eligibility for BCMH is determined case by case based on:

  • A percentage of the federal poverty income guidelines
  • The family’s taxable income
  • The medical care the child needs
  • A calculation of the family’s maximum ability to pay for health care
  • Amount spent on private health insurance
  • Amount spent on weekly child care

BCMH does not count personal assets such as a home, car or savings account when determining financial eligibility. Also, income from child support, stepparent income or social security income (SSI) for the child is not counted.

When a child’s doctor applies to BCMH for treatment services a child needs, BCMH will send the parent or legal guardian a financial application packet unless the child is active on the Medicaid program. It is important that all the instructions in the packet are followed. A form called the Combined Program Application (CPA) will be in the packet. The CPA is the financial application form for BCMH. It must be filled out and mailed to BCMH along with 3 pay stubs from each parent/adult client who is employed and a copy of their most recent federal income tax form (1040) and verification of child care expenses. A child receiving benefits through Medicaid, SSI or WIC is automatically financially eligible for BCMH treatment services, regardless of the parent’s income.

BCMH and Medicaid

Families who meet the income standards for the Medicaid program of the Ohio Department of Medicaid (ODM) will be required to apply to that program for coverage of medical services for their child. The Medicaid Guidelines are in the BCMH financial application packet, along with instructions on how to apply. If over-income for the Medicaid Program, the CPA, denial letter from Healthy Start and income verifications must be sent to BCMH to determine eligibility for BCMH.

If a Family is Determined to be “Over Income” for the BCMH Program

If BCMH sends the family a denial letter, stating they are “over-income” for the Treatment Program, they will also receive information about the BCMH’s cost share program. They will be given a cost share dollar amount and BCMH Information Sheet: Steps to Meet your Cost Share on how they can meet that cost share amount. When the family provides proof to BCMH that they have spent that amount of money on medical costs including dental, and/or vision bills for any member of their family, they will have met their cost share. On the date the cost share is met, the child will become eligible for the Treatment Program for one year.

 

 Last Updated: 6/29/2017