Complex Medical Help Program
Complex Medical Help Program (CMH): State Program which provides medical coverage for children up to 25 years of age who have a medical handicapping condition and meet the medical and financial eligibility criteria. Our nurses work as case-managers doing home visits with eligible families. CMH is a health care coverage program (similar to insurance) in the state of Ohio. We help link families of children with special health care needs to a network of quality physicians.
Frequently Asked Questions
Financial eligibility for CMH 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
CMH 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.
Families who meet the income standards for the Healthy Start Program of the Ohio Department of Job and Family Services (ODJFS) will be required to apply to that program for coverage of medical services for their child.
A child with a complex medical condition is one who suffers from a chronic disease, defect, or a congenital or acquired condition.
Medically eligible conditions meet the following guidelines:
- Restricts physical development and is expected to decrease health functioning.
- Condition is able to be improved with treatment services or goods.
- Is either a tumor or a congenital abnormality or affects one or more of the following body systems: endocrine and metabolic systems, respiratory system, blood and blood-forming organs, digestive system, nervous system , genitourinary system, sensory organs , musculoskeletal system, and circulatory system.
Examples of Eligible Conditions:
- AIDS
- Heart defects
- Birth defects
- Hemophilia
- Cancer
- Cleft lip and palate
- Myelodysplasia
- Cystic fibrosis
- Scoliosis
- Diabetes
- Inguinal hernia
- Cerebral palsy
- Malignancies
- Sickle cell anemia
- Hearing loss
- Spinal injuries
Children under the age of 25 with a complex medical condition, who meet the medical and financial eligibility criteria, and adults with Cystic Fibrosis. A list of some of the medical qualifications are located at the bottom of this page. Individuals must be residents of the State of Ohio to qualify for this program.
CMH is a state-administered program that operates within Ohio Department of Health (ODH). CMH receives funding for services from the federal Maternal and Child Health Block Grant, state general revenue funds, county tax funds, third-party reimbursements and donations.