Administrative Policies

These administrative policies apply to the Ohio Marketplace plans.

Administrative policies offer guidance on determination of medical necessity, investigation and experimental services.

The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

Current Administrative Policies

The following policies have moved to the Pharmacy Policy page:

  • COVID-19 Vaccination
  • Medical Necessity – Off Label
  • Medical Necessity for DAW
  • Medical Necessity for Medical Benefit Medications
  • Medical Necessity for Non-Formulary Medications
  • Multi-ingredient Compound Policy

Archived Administrative Policies