Traditional MedicareAdministrativeMedium impact
5160:1-3-02.2 - Medicare buy-in. (Amend/Final File)
Ohio Medicaid·OH·Medical Policy
Effective date
Nov 1, 2023
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid has finalized an amendment to their Medicare buy-in policy (Rule 5160:1-3-02.2) effective November 1, 2023. This policy governs how Ohio Medicaid coordinates with Medicare coverage for dual-eligible beneficiaries.
Action Required
By November 1, 2023: Billing teams in Ohio should review dual-eligible Medicare/Medicaid patient accounts to ensure proper coordination of benefits and billing order compliance with updated Ohio Medicaid Medicare buy-in requirements. Verify that Medicare is being billed as primary payer before submitting claims to Ohio Medicaid for dual-eligible patients.