Written by a parent, not a doctor. Nothing here is medical advice.

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Ohio program

Help paying a health-plan premium (CMH)

CMH can pay health insurance premiums for families whose child is in its treatment program.

What it is

CMH can pay health insurance premiums for families whose child is in its treatment program.

CMH premium help starts with enrollment in its treatment program, not a requirement to have Medicaid. The team checks the actual premium or COBRA situation, any insurance-network barrier and the rule’s payment conditions. Having private coverage or stopping work alone does not show that a premium can be paid.

Eligibility rules
  • The child must participate in CMH treatment.
  • Under one route, the family has COBRA or annual premiums exceeding 2.5% of gross annual earnings. The director must find the payment cost-effective.
  • Another route applies when primary-insurer network mandates prevent access to CMH-authorized benefits.
What you get
  • Payment of an approved family health premium.
  • A decision within 30 days after CMH receives the last required document.
What this covers
  • The value depends on the approved premium. CMH's letter explains what it pays and how.
If you decide to apply
  1. Ask CMH at 800-755-4769 whether it can pay your family's health premium while your child is in its treatment program.
  2. Useful records include the COBRA notice or annual premium figures, gross annual earnings and any insurance-network problem.

Ohio Department of Health CMH: 800-755-4769 · Official page ↗

After you apply
  • The 30-day decision clock starts after the last required document, not the first inquiry.
Good to know

Your child must be in CMH treatment first. This is a CMH benefit, with different rules from Medicaid premium assistance.

Other details
  • The premium-assistance rule took effect September 1, 2008.
  • This card concerns CMH premium assistance. Your social worker can ask Ohio Medicaid whether a separate Medicaid or CHIP premium-payment route is available and how its rules differ.
Official sources
Ask your social worker

“Could CMH pay our premium, and what conditions would we need to keep meeting? If the savings make it worthwhile, could you help us prepare the request?”

Why I’m asking: I want to understand whether keeping our insurance could cost us less.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Send the COBRA notice or premium figures and your pay before taxes, and ask for the decision date.

Your social worker

The social worker checks that your child is in CMH treatment and helps put the request together.

The care team

Nothing beyond the CMH medical application.

Who decides
Complex Medical Help at the Ohio Department of Health decides, within 30 days of the last document.
Ask the agency
“My child is in CMH treatment and we are on COBRA (or our premiums are over 2.5% of our pay). Can CMH pay the premium under its premium-assistance rule, and what is the last document you need?”

How to apply

First step: Call CMH at 800-755-4769 and ask for premium assistance under its premium rule. Send the COBRA notice or the premium figures, with your pay before taxes.

  1. If COBRA starts or premiums pass 2.5% of earnings, ask CMH for premium assistance in writing.

Official application / program page ↗

Where it starts: Through the CMH medical and financial referral; call 800-755-4769 and ask for premium assistance under rule 3701-43-20

What to gather

  • COBRA election notice or the plan's premium schedule
  • Pay before taxes for the year (last W-2 or pay stubs)
  • CMH treatment letter

How long: 30 days after the last required document.

What a yes looks like

A CMH letter approving premium payment and saying how it is paid.

What a no looks like, and the next move

Ask which test failed: COBRA, the 2.5% rule, or the cost comparison. Ask whether the other rule applies instead, the one for families whose insurer's network blocks CMH-approved care.

Watch out

  • Your child must be a CMH treatment patient first.
  • The 30-day deadline starts at the last document; ask which document is last.
  • Do not call it HIPP at the county. It is a health-department rule, not Medicaid.

If they say no, quote this: Ohio Administrative Code 3701-43-20 (CMH assistance with health insurance premiums).

The numbers and the rules

The arcane layer, kept on purpose. Checked September 9, 2026.

What it is worth

Health premiums paid for a CMH treatment family that is on COBRA, or paying more than 2.5% of pay before taxes in premiums. Decided within 30 days of a complete request.

  • $2.5 (or COBRA coverage; plus a cost-effectiveness finding) — Premium threshold
  • $30 — Decision after the last required document

Covers: Premium payment for the family's health insurance (method NOT FOUND)

What it costs the family: None beyond the ordinary CMH cost share.

The eligibility facts, as published

Cmh treatment
the child must be in the CMH treatment program
Gate a
COBRA coverage, or annual family premiums exceeding 2.5% of gross annual earnings, and the director finds it cost-effective
Gate b
the family is unable to access CMH-authorized benefits because of primary payor network mandates
Decision
within 30 days of the last document
Rule effective
2008-09-01

Decisions this site cannot make: CMH cost-effectiveness finding

Expect friction on: Dedicated request form NOT FOUND · Practice processing time NOT FOUND

The trap: It is a CMH benefit, not Medicaid HIPP. The 30 days run from the last document, so an incomplete request has no deadline at all.

Where I read this

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