Medicaid Long-Term Care Guide in Ohio
Long-term care eligibility, benefits, and how to apply through the Ohio Department of Medicaid (ODM).
Inside Ohio's Program
State and federal dollars fund Ohio Medicaid jointly, with Ohio administering the program under rules the federal government sets. The Ohio Department of Medicaid is the agency in charge. Long-term care coverage here spans nursing home care and assisted living, plus non-medical services and supports intended to let frail seniors stay in their own homes rather than move into a facility.
Administered by the Ohio Department of Medicaid (ODM).
How Ohio Divides Its Coverage
Institutional / Nursing Home Medicaid
Entitlement. Anyone who is eligible receives assistance. Benefits apply inside Medicaid-certified nursing homes.
Level of care: Nursing Home
Medicaid Waivers / Home and Community Based Services (HCBS)
Limited slots. Participation is capped and wait lists can develop. These services are designed to delay or prevent a nursing home admission, delivered at home, at adult day care, or in assisted living.
Level of care: Nursing Home
Regular Medicaid / Aged, Blind, or Disabled (ABD)
Entitlement. Meeting the requirements guarantees assistance. This is not long-term care Medicaid, though it can cover certain long-term care benefits including personal care assistance and adult day care.
Level of care: Help with ADLs
2026 Ohio Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waivers / Home and Community Based Services†
Regular Medicaid / Aged, Blind, or Disabled
*All of a beneficiary's monthly income, with the exception of a Personal Needs Allowance of $75 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must be paid to the nursing home. This is called a Patient Liability.
†Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
Explore Ohio Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Ohio.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Compare Medicaid Programs — Ohio
How the main LTC programs available in Ohio compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $17–20/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | $50–65/day | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Ohio Medicaid programs
PASSPORT Waiver (consumer-directed)
Structured Family Caregiving
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Ohio
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Structured Family Caregiving (SFC) — tax-free daily stipend
Available in OhioHow to enroll: Contact Careforth (careforth.com) or FreedomCare (freedomcare.com) — both operate in Ohio and handle enrollment at no charge.
Consumer-directed care — hourly pay
Available in OhioHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: ODA · aging.ohio.gov · Careforth for SFC
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Ohio
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Ohio. The process typically takes 45–90 days from application to first paycheck.
Apply in Ohio: ODA · aging.ohio.gov · Careforth for SFC
Medicaid Eligibility Screener — Ohio
Answer 7 quick questions — we'll check the financial and care requirements for Ohio and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Choose one to continue — tap a button below.
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
See how Medicaid fits into your long-term care plan
Our free Affordability Calculator shows how Medicaid works alongside your savings, income, and care costs.
Key Rules at a Glance
- Nearly all income that a Medicaid applicant receives is counted towards Medicaid's income limit, including employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In OH, the Veteran's Aid & Attendance, which is above and beyond the Basic VA Pension, does not count.
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,705 (eff. 7/1/26 – 6/30/27). If a non-applicant spouse's income is under this amount, income can be transferred from the applicant spouse.
- The non-applicant spouse can further increase their Spousal Income Allowance if housing and utility costs exceed a 'shelter standard' of $811.50 / month (eff. 7/1/26 – 6/30/27). The maximum allowance is $4,066.50 / month in 2026.
- For Regular Medicaid, both spouses' income is counted. There is no MMMNA for a non-applicant spouse.
- In Ohio, persons who are found eligible for SSI are automatically approved for Medicaid.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, bank accounts (money market, savings, checking), and real estate in which one does not reside.
- In Ohio, IRAs / 401Ks in 'payout status' are exempt — meaning one's Required Minimum Distribution (RMD) is being withdrawn.
- Exempt (non-countable) assets include personal belongings, household furnishings, an automobile, irrevocable burial trusts, and generally one's primary home.
- All assets of a married couple are considered jointly owned regardless of the Medicaid program.
- The CSRA allows the non-applicant spouse to retain 50% of the couple's assets, up to $162,660 (2026). If the non-applicant's half is under $32,532, up to $32,532 can be retained.
- There is no CSRA for Regular Medicaid.
- The home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $752,000 (in 2026).
- Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Ohio's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Ohio has a 5-year (60-month) Medicaid Look-Back Period for Nursing Home Medicaid and Medicaid Waiver applications.
- Medicaid scrutinizes all asset transfers to ensure none were gifted or sold under fair market value.
- Violations result in a Penalty Period of Medicaid ineligibility.
- The Look-Back Period does not apply to Regular Medicaid.
- The IRS Gift Tax Exemption ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this exemption violates Medicaid's Look-Back Period.
- MMMNA: $2,705 · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,705 (eff. 7/1/26 – 6/30/27). Income can be transferred from the applicant spouse if the non-applicant's income is below this level.
- The non-applicant spouse can increase their allowance if housing/utility costs exceed $811.50 / month, up to a maximum of $4,066.50 / month in 2026.
- The CSRA allows the non-applicant spouse to retain 50% of assets up to $162,660 (min $32,532) in 2026.
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Qualified Income Trusts (QITs) — Also called Miller Trusts, QITs allow persons over Medicaid's income limit to become income-eligible for Nursing Home Medicaid or a Waiver. 'Excess' income is deposited into an irrevocable trust managed by a trustee and can only be used for specific purposes (e.g., medical expenses).
- Asset Spend-Down — Spend excess assets on non-countable items such as home modifications (wheelchair ramps, stair lifts), prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to employ strategies to become eligible and protect your home from Medicaid's Estate Recovery Program.
Ohio uses Qualified Income Trusts (Miller Trusts) for persons whose income exceeds the limit for Nursing Home Medicaid or HCBS Waivers. Ohio does not have a Medically Needy / Spend-Down program for long-term care Medicaid.
Ohio Medicaid Programs
PASSPORT Waiver
Pre-Admission Screening System Providing Options & Resources Today. Provides a variety of long-term services and supports, including adult day care, home care, home modifications, and medical equipment/supplies.
Assisted Living Waiver
Assists persons 21+ years old in living in residential care facilities and assisted living residences. While the cost of room and board is not covered, this program pays for care services. Not all Ohio assisted living residences accept waiver participants.
MyCare Ohio / Next Generation MyCare
A mandatory managed care Medicaid program for persons dually eligible for Medicaid and Medicare. Benefits may include adult day care, assisted living services, memory care, home modifications, meal delivery, and personal emergency response systems. Transitioning to Next Generation MyCare starting Jan. 1, 2026, with statewide rollout throughout 2026.
Program of All-Inclusive Care for the Elderly (PACE)
Combines the benefits of Medicaid, including long-term care, and Medicare into a single program. Additional benefits, such as dental and eye care, may be available.
Money Follows the Person (HOME Choice)
Also called HOME Choice in Ohio. This federal program helps institutionalized persons who are eligible for Medicaid to transition back home or into the community.
How to Apply
- Apply online at Ohio Benefits
- Call the Consumer Hotline at 1-800-324-8680
- Apply in person at one's county Job and Family Services office
- Contact the local Area Agency on Aging for questions and application assistance
Applicants should be certain all eligibility requirements are met prior to applying. For persons over the income and/or asset limits, Medicaid Planning is strongly encouraged. The application process can be complicated and specific documentation must be included.
More Ohio Long-Term Care Resources
Sources & references
Verified October 2026- Centers for Medicare & Medicaid Services: Long-Term Services & Supports
- Administration for Community Living: State Medicaid Agencies
- Centers for Medicare & Medicaid Services: Medicaid Eligibility
- American Council on Aging: About Medicaid Planning Assistance
- Ohio Department of Medicaid (ODM): Ohio Medicaid — Official site