The Hospital Care Assurance Program, known as HCAP, is designed to provide financial relief to Ohio residents struggling with unpaid hospital bills. This crucial program is available to individuals and families in Ohio who are at or below the federal poverty level and do not qualify for Medicaid coverage.
HCAP also plays a vital role in supporting Ohio hospitals. It allocates funds to hospitals that disproportionately handle significant costs related to uncompensated care. This ensures that hospitals can continue to provide essential services to indigent and uninsured individuals across Ohio.
Administered by the Ohio Department of Medicaid, HCAP operates as a state and federally funded initiative.
Who Benefits from the Hospital Care Assurance Program?
HCAP serves two primary groups:
- Eligible Ohio Patients: Ohioans facing financial hardship due to hospital expenses can find assistance through HCAP. To be eligible, individuals must meet specific income criteria (at or below the federal poverty level) and must not be eligible for Medicaid. This program acts as a safety net for those who are uninsured or underinsured and cannot afford necessary hospital care.
- Ohio Hospitals: Hospitals that treat a large number of patients who are unable to pay for their care receive essential funding through HCAP. This funding helps to offset the costs of uncompensated care, allowing these hospitals to maintain their services and continue serving vulnerable populations within Ohio. This is particularly important for hospitals with a high percentage of low-income or uninsured patients.
Accessing Information and Applying for HCAP
For patients and families seeking to apply for HCAP, the application process is managed directly by the hospital where the medical services were provided. Individuals interested in applying or those with questions about an existing application should directly contact the relevant hospital for guidance and support.
To gain a deeper understanding of HCAP, including details on free care rules, eligibility criteria, application procedures, and program audits, the Ohio Hospital Association (OHA) provides a comprehensive Frequently Asked Questions (FAQs) resource. This document offers valuable insights into the program’s operational guidelines and requirements as outlined in the Ohio Administrative Code (OAC) 5160-2-17.
HCAP and Medicaid: Ensuring Comprehensive Coverage
It’s important to note that Ohio Medicaid guidelines are structured to encompass most Ohio residents who qualify for free hospital care under programs like HCAP. Hospitals are encouraged to assist patients in applying for Medicaid as part of the free care application process. This ensures that individuals receive the most comprehensive coverage available to them, potentially beyond the scope of HCAP alone.
HCAP as Ohio’s Medicaid Disproportionate Share Hospital (DSH) Program
The Hospital Care Assurance Program in Ohio serves as the state’s Medicaid Disproportionate Share Hospital (DSH) program. DSH programs are federally mandated and were established to provide crucial financial support to hospitals that serve a high proportion of Medicaid and low-income patients. HCAP payments are supplementary to standard Medicaid hospital payments, further strengthening the financial stability of hospitals that are essential providers for vulnerable populations.
Resources for Providers
Healthcare providers seeking detailed information on program rules and guidelines can access all public rules and provider manuals on the Ohio Department of Medicaid’s website.
