Odm 06723 2025

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The document is a 'Designation of Authorized Representative' form from the Ohio Department of Medicaid, allowing an applicant or recipient to authorize another person or company to act on their behalf regarding various assistance programs, including Food Assistance, Cash Assistance, Medicaid, and Child Care. It outlines the scope of authority granted, duration of authorization, and requires signatures from both the person granting authority and the authorized representative.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (71 Votes)
2014	4.3 Satisfied (55 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I check if my Ohio Medicaid is active?

Ohioans currently enrolled in Medicaid should take steps to ensure that their information is up to date: Check the status of your coverage using the Ohio Benefits Self Service Portal at benefits.ohio.gov.

Can I check my Ohio Medicaid status online?

Your Medicaid benefits will need to be renewed annually and you will be notified when it is time to renew. Click here for more information about the renewal process.

What is the address for Medicaid claims in ohio?

Check the status of your coverage using the Ohio Benefits Self Service Portal at benefits.ohio.gov. Update your address on the Department of Medicaid website.

How to check if your Medicaid is active online?

Log into your states Medicaid portal Many states have online portals where you can check your Medicaid coverage status. If you already created an account when you applied, log in to see any updates or changes to your status.

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