(A)A managed care organization that offers the health plan in which a healthy Ohio program participant enrolls shall issue a debit swipe card to be used to pay only for the following:
(1)Until the amount of the noncore portion of the participant's buckeye account is zero, the costs of health care services that are covered by the health plan and provided to the participant by a provider participating in the health plan;
(2)The participant's copayments under division (C) of section5166.401of the Revised Code;
(3)Subject to rules authorized by section5166.409of the Revised Code, the costs of health care services that are medically necessary for the participant but not covered by the health plan.
(B)(1) A healthy Ohio program participant's debit swipe card shall be credited with one po
Free access — add to your briefcase to read the full text and ask questions with AI
(A) A managed care organization that offers the health plan in which a healthy Ohio program participant enrolls shall issue a debit swipe card to be used to pay only for the following:
(1) Until the amount of the noncore portion of the participant's buckeye account is zero, the costs of health care services that are covered by the health plan and provided to the participant by a provider participating in the health plan;
(2) The participant's copayments under division (C) of section5166.401of the Revised Code;
(3) Subject to rules authorized by section5166.409of the Revised Code, the costs of health care services that are medically necessary for the participant but not covered by the health plan.
(B)(1) A healthy Ohio program participant's debit swipe card shall be credited with one point for each of the following:
(a) Each dollar of medicaid funds deposited into the participant's buckeye account under division (B) of section5166.402of the Revised Code;
(b) Each dollar contributed to the participant's buckeye account under divisions (C) and (D) of section5166.402of the Revised Code;
(c) Each point awarded to the participant under section5166.404of the Revised Code.
(2) Each time a healthy Ohio program participant uses the participant's debit swipe card, the amount for which the card is used shall be deducted from the number of points on the card as follows:
(a) If the card is used for the purpose specified in division (A)(1) of this section, the deduction shall come from the points representing the noncore portion of the participant's buckeye account.
(b) If the card is used for the purpose specified in division (A)(2) or (3) of this section, the deduction shall come from the points representing the core portion of the participant's buckeye account.
(C) A healthy Ohio program participant's debit swipe card shall do all of the following:
(1) Verify the participant's eligibility for the healthy Ohio program;
(2) Determine whether the service the participant seeks is covered under the health plan;
(3) Determine whether the provider from which the participant seeks the service is a participating provider under the health plan;
(4) Be linked to the participant's buckeye account in a manner that enables the participant to know at the point of service what will be deducted from the noncore portion and core portion of the participant's buckeye account for the service and how much will remain in each portion of the account after the deduction.