Long-Term Care Medicaid in Ohio: 2026 Guide

In Ohio, Long-Term Care Medicaid is run by the Ohio Department of Medicaid (ODM), and applications are handled by each county’s Job and Family Services (JFS) office. It can pay for nursing home care and for care at home or in assisted living for people who need a nursing-home level of care and have limited income and assets. This guide explains the 2026 rules in plain language.

At a glance: Ohio 2026 figures

Figures last updated for 2026. Sources are listed at the end of this page.

Figures change periodically. Double-check current amounts with the Ohio Department of Medicaid before relying on them.

What Long-Term Care Medicaid covers in Ohio

Nursing home care. Medicaid pays for care in a Medicaid-certified nursing facility, including room, meals, nursing care and therapy. You pay most of your monthly income toward the cost (see Income rules), and Medicaid pays the rest.

Care at home and in the community. Ohio uses home and community-based services (HCBS) waivers so people can get help without moving to a nursing home. The main programs for older adults are:

• PASSPORT Waiver: in-home help such as personal care, homemaker services, adult day care, meals and emergency response, for people 60 and older.
• Assisted Living Waiver: pays for services in a Medicaid-certified assisted living home.
• Ohio Home Care Waiver: home care services for people under 60 with disabilities.
• MyCare Ohio Waiver, part of the Next Generation MyCare program: for people who have both Medicare and Medicaid. Next Generation MyCare started in 29 counties on January 1, 2026 and reached the rest of Ohio between April 1 and August 1, 2026. People who were on PASSPORT, Assisted Living or Ohio Home Care when they joined Next Generation MyCare were moved to the MyCare Ohio Waiver, with the same or more benefits. People not in Next Generation MyCare stay on their original waiver.
• PACE, an all-in-one care program, is available in some areas.

Assisted living. The Assisted Living Waiver (or the MyCare Ohio Waiver) pays for care services in assisted living. It does not pay for room and board; the resident pays that from their own income.

Who qualifies

To get Long-Term Care Medicaid in Ohio, a person generally must:

• be 65 or older, or blind or disabled;
• live in Ohio and be a U.S. citizen or qualified non-citizen;
• need a nursing-home level of care. A level-of-care assessment looks at help needed with daily activities such as bathing, dressing, eating, toileting and moving around, and at supervision needed because of memory loss. For home care, the assessment is done by the local Area Agency on Aging (as the PASSPORT administrative agency) or the managed care plan;
• meet the income and asset rules below.

Income rules

Ohio has an income cap. In 2026, an applicant’s gross monthly income (before deductions such as Medicare premiums) must be $2,982 or less.

If income is higher, Ohio does not simply deny coverage. The person can set up a Qualified Income Trust (QIT), also called a Miller trust. Income above the limit is deposited into a special bank account each month. The trust must be irrevocable, hold only the applicant’s income, and repay Medicaid when the person dies. The signed trust and proof of the monthly deposits are given to the county JFS with the application.

Once you are on Medicaid in a nursing home, most of your income goes to the nursing home each month as your “patient liability.” You keep a personal needs allowance of $75 a month for things like clothing and haircuts. Money can also be set aside for a spouse at home (see Spousal protections) and for health insurance premiums.

Asset rules

A single applicant can have no more than $2,000 in countable assets in 2026. For a couple who both need care, the limit is $3,000.

Countable assets include cash, checking and savings accounts, CDs, stocks, bonds, mutual funds, retirement accounts that can be cashed in, the cash value of life insurance above small amounts, and real estate other than the home.

Usually exempt (not counted):

• Your home, if you live there or plan to return, or your spouse or a dependent relative lives there, and your equity is $752,000 or less
• One vehicle
• Household goods and personal belongings
• Irrevocable prepaid funeral contracts and certain burial plots
• Some income-producing property

Spending assets on things you need (paying debts, home repairs, a prepaid funeral) is allowed. Giving them away is not (see Look-back).

Spousal protections

When one spouse needs long-term care and the other stays at home, Ohio follows federal rules that keep the spouse at home from becoming impoverished.

• Assets: The spouse at home can keep a Community Spouse Resource Allowance (CSRA). In 2026 it is at least $32,532 and at most $162,660. The home, one car and personal belongings are not counted toward this.
• Income: The spouse at home keeps all income in their own name. If it is below the Minimum Monthly Maintenance Needs Allowance (MMMNA) of $2,705 (from July 1, 2026), part of the applicant’s income can be given to them to bring them up to that level, and higher shelter costs can raise this up to $4,066.50 a month.

Look-back and penalties

When you apply, Ohio looks back at the 60 months (5 years) before the application date. This is called the look-back period. The state checks whether you, or your spouse, gave away money or property, or sold something for less than it was worth, during that time.

Common examples of transfers that can cause a problem:

• Cash gifts to children or grandchildren, even small yearly gifts. (A gift that is fine for federal gift-tax purposes can still count for Medicaid.)
• Adding a child’s name to a house deed or bank account in a way that gives them part ownership.
• Selling a house or car to a relative for much less than it is worth.
• Paying a family member for care without a written agreement made at the time.

Some transfers are allowed, such as transfers between spouses, or transferring a home to a child who is blind or disabled.

How the penalty works. If the state finds a transfer that is not allowed, it does not deny Medicaid forever. Instead, it sets a penalty period: a stretch of time when Medicaid will not pay for long-term care. The state divides the amount given away by the penalty divisor ($8,669 a month).

Example: Suppose you gave your daughter $50,000 three years before applying. $50,000 divided by $8,669 is about 5.8 months. Medicaid would not pay for long-term care for about 5.8 months.

The penalty period starts only once you have applied, are otherwise eligible, and are in (or need) long-term care. This is why gifts made while someone is healthy can still matter years later. If a gift is returned in full, the penalty can be removed.

Estate recovery in Ohio

After a person who received Medicaid dies, Ohio tries to recover what it paid from the person’s estate. The Ohio Attorney General’s Office handles this for ODM.

• Whose estates: people who were permanently in a nursing home (any age), and people 55 or older for benefits paid after age 55.
• What is recovered: Medicaid payments for services, including monthly payments to a managed care plan, even if those are more than the actual cost of care.
• The home can be included. A will does not protect property from recovery.
• When it is put off: while a spouse is alive, or if there is a child under 21 or a child of any age who is blind or disabled.
• Hardship: survivors can ask for an undue hardship waiver, for example if the property is a family farm or business that is their only source of income.

The executor of the estate is responsible for notifying the Attorney General’s Office of the death.

How to apply

Apply to Ohio Medicaid in one of these ways:

• Online: benefits.ohio.gov
• In person or by mail at your county Job and Family Services office
• By phone through the Ohio Medicaid Consumer Hotline (number on medicaid.ohio.gov)

Tell them you are applying for long-term care (nursing home or waiver services). For home care, you will also need a level-of-care assessment, arranged through your local Area Agency on Aging or your managed care plan.

Gather what you can before you apply. The caseworker may ask for:

• Photo ID, Social Security card and Medicare card
• Proof of age and of U.S. citizenship or immigration status
• Proof that you live in the state (for example, a utility bill or lease)
• Proof of all income: Social Security award letter, pension statements, annuity statements
• Bank, credit union and investment statements (often for the full 60-month look-back period)
• Deeds, property tax bills and the value of any real estate
• Life insurance policies (showing cash value) and prepaid funeral or burial contracts
• Vehicle titles
• Health insurance cards and long-term care insurance policies
• Power of attorney or guardianship papers, if someone is applying for you
• For a spouse at home: their income and assets too, since both spouses’ assets are counted at the start

If you cannot find a document, apply anyway and tell the caseworker. They can explain what else is accepted.

If you are using a Qualified Income Trust, include the signed trust, proof of the bank account and proof of monthly deposits.

Free public help in Ohio

• Ohio Department of Medicaid and your county JFS office: questions about applications and eligibility.
• Area Agency on Aging: Ohio’s regional aging agencies run PASSPORT assessments and can explain home care options. Find yours through the Ohio Department of Aging.
• OSHIIP (Ohio Senior Health Insurance Information Program): Ohio’s free Medicare counseling program (SHIP), run by the Ohio Department of Insurance.
• Long-Term Care Ombudsman: a free, independent advocate for people in nursing homes and assisted living, through the Ohio Department of Aging.

Recent and upcoming changes

A 2025 federal law (Public Law 119-21) makes two changes that affect Long-Term Care Medicaid in every state, including Ohio:

• Retroactive coverage gets shorter on January 1, 2027. Today, Medicaid can pay bills from up to 3 months before the month you apply, if you would have qualified then. For applications from January 1, 2027, this window shrinks to 2 months for older adults and people with disabilities. In plain terms: from 2027, it matters more to apply soon after care starts, so that earlier bills are not left unpaid.
• Home equity cap on January 1, 2028. States will no longer be able to set a home equity limit above $1,000,000 (except for some farm property). Ohio’s 2026 home equity limit, $752,000, is already below the new cap, so this change is not expected to affect Ohio’s limit.

The federal amounts that change each year (for example, the allowances for a spouse at home) will be updated on this page for 2027 once they are published.

State programs

Each program below has its own page with who qualifies, services, how to apply and waiting lists:

• Ohio PASSPORT Waiver
• Ohio Assisted Living Waiver
• MyCare Ohio

Frequently asked questions

Does Medicaid take my house in Ohio? Not while you are alive and it is exempt. Your home does not count against the $2,000 limit if you plan to return or your spouse lives there (and equity is under $752,000). After death, the home can be subject to estate recovery unless a spouse or a young or disabled child survives.

My income is a little over $2,982. Can I still qualify? Yes, if you set up a Qualified Income Trust and deposit the extra income into it each month. The county JFS office can explain the paperwork.

Is PASSPORT still available? Yes, for people who are not enrolled in Next Generation MyCare. People who have both Medicare and Medicaid and joined Next Generation MyCare in 2026 receive similar services through the MyCare Ohio Waiver instead.

Will Medicaid pay for assisted living? It can pay for the care part through the Assisted Living Waiver or MyCare Ohio Waiver, in a certified facility. Room and board are paid by the resident.

How much can my husband or wife keep? In 2026, between $32,532 and $162,660 in assets, plus the home, a car and belongings, and enough income to reach at least $2,705 a month.

Can I give my grandchildren gifts? Gifts made within 5 years before applying can lead to a penalty period. Ask the county JFS office or your Area Agency on Aging how a specific transfer would be treated.

Figures change periodically. Double-check current amounts with the Ohio Department of Medicaid before relying on them.

Sources

• Ohio Department of Medicaid, Next Generation MyCare program
• ODM, Next Generation MyCare Member FAQ
• Ohio Admin. Code 5160:1-6-03.2, Qualified income trusts
• Ohio Admin. Code 5160:1-2-07, Estate recovery
• ODM, Estate Recovery brochure (ODM 07400)
• Ohio Benefits application
• OSHIIP
• CMS, 2026 SSI and spousal impoverishment standards
• Public Law 119-21 (2025)

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.