Ohio Medicaid has no explicit policy regarding transgender-related health care.
OH OAC 5160-2-03 (2017; since 2015)
5160-2-03 Conditions and limitations.
(A) Conditions and limitations applicable to both inpatient and outpatient hospital services.
(2) Inpatient or outpatient services related to the provision of the services described in this rule are not covered:
(e) Gender transformation.
Even though there is an explicit exclusion on the books, both the Washington Post and Bloomberg Law report that Ohio is not enforcing the exclusion.
Managed care organizations operating under Ohio's Medicaid program have clinical policy guidelines for covering transgender-related care.
If you have been denied transgender-related care under an Ohio Medicaid plan, please contact us.
Updated on Apr 29, 2021