Group VIII Overview

Due to new federal laws, Medicaid eligibility requirements will be changing for individuals eligible for and enrolled in Group VIII (Group 8) coverage (also known as MAGI Adult or Ribicoff coverage). The new rules will introduce a Work and Community Engagement Requirement for certain non-exempt individuals, ages 19 - 64, to demonstrate ongoing participation in work or community activities for a minimum of 80 hours per month as a condition of coverage.

What is changing?

To maintain Medicaid eligibility, some Group VIII individuals must demonstrate that they meet new qualifying activities such as work, education, job training or community service, unless they meet an exemption.

How do I know if this applies to me?

The new requirement only applies to individuals eligible for and enrolled in Group VIII coverage, which refers to adults aged 19 through 64 who have Medicaid because their income is at or below 138% of the Federal Poverty Level.

These changes do not affect individuals who have Medicaid for reasons other than income, or those who have certain health conditions or meet other exemptions.

To find out if you are part of Group VIII, you can log in to your Self-Service Portal (SSP) account and look on the “View My Benefits” page. You can also look at a recent notice from ODM if you do not use the Self-Service Portal.

What should I do to learn more?

You can select the Exemptions tile on ODMs website, to see if you may meet an exemption or the Qualifying Activities tile to see if you may meet the work and community engagement requirement.

The Ohio Department of Medicaid (ODM) will provide more information when it is available, so please keep checking this page. 

Check out the FAQs below. 

Note - The information presented here is subject to change prior to program implementation based on future CMS guidance.