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Ohio Medicaid for Senior Care

Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Ohio.

7.6 million Medicaid long-term care recipients nationwide

Ohio Department of Medicaid

Application Helpline

1-800-324-8680

Monday-Friday, 8am-5pm local time

Processing Time

30-45 days for standard Medicaid; PASSPORT and Assisted Living Waiver applications typically take 45-60 days. Ohio has generally adequate capacity with regional variations.

Ohio Medicaid Eligibility Requirements (2026)

To qualify for Medicaid long-term care in Ohio, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Ohio follows federal Medicaid guidelines with some state-specific variations.

Income Limits

Individual Applicant

$2,982/month

Married Couple (One Applying)

$5,964/month

Income includes Social Security, pensions, annuities, interest, dividends, and rental income.

Asset Limits

Individual Applicant

$2,000

Community Spouse (At-Home Spouse)

$3,000

Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.

5-Year Look-Back Period

Ohio Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $8,389/month average (semi-private), $9,211/month (private) (the average monthly nursing home cost in Ohio).

Medical Eligibility

Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.

Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.

What Medicaid Covers in Ohio

Nursing Home Care

Medicaid pays 100% of nursing home costs in Ohio once eligibility is established. The average monthly cost is $8,389/month average (semi-private), $9,211/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.

Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.

Assisted Living Coverage

Assisted Living Waiver: Ohio has a dedicated Medicaid waiver specifically for assisted living (residential care facilities). The waiver covers personal care services, medication administration, activities, and care coordination. Room and board costs are not covered—residents typically pay $600-1,200/month from their income for housing, while Medicaid covers care services through the waiver.

Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.

Home and Community-Based Services (HCBS) Waivers

Ohio offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.

PASSPORT Waiver

Ohio's largest HCBS waiver serving individuals age 60+ who meet nursing facility level of care. Provides adult day services, care coordination, emergency response systems, home-delivered meals, home medical equipment, homemaking and personal care, non-medical transportation, nutrition consultation, out-of-home respite, social work counseling, home modifications, and assistive technology. Over 30,000 participants statewide.

Program Details →

Assisted Living Waiver

Serves individuals age 18+ who meet nursing facility level of care and choose to reside in licensed residential care facilities (Ohio's term for assisted living). Covers monthly service package including personal care, medication administration, social activities, and care coordination. Approximately 10,000 participants.

Program Details →

Ohio Home Care Waiver

Serves adults age 18-59 with disabilities who meet nursing facility level of care. Provides similar services to PASSPORT but designed for younger adults with physical disabilities.

Program Details →

How to Apply for Medicaid in Ohio

Ohio Medicaid applications typically take 30-45 days for standard Medicaid; PASSPORT and Assisted Living Waiver applications typically take 45-60 days. Ohio has generally adequate capacity with regional variations.. Starting the process early and submitting complete documentation helps avoid delays.

Application Methods

You can apply for Medicaid in Ohio through:

  • Online at benefits.ohio.gov
  • Phone: 1-800-324-8680 (Ohio Medicaid Consumer Hotline)
  • Download application and mail to county Department of Job and Family Services
  • In-person at local county DJFS office (88 county offices statewide)

Step 1: Gather Required Documents

Before starting your application, collect:

  • Birth certificate and Social Security card
  • Proof of citizenship (passport, naturalization)
  • 5 years of bank statements
  • Investment and retirement account statements
  • Property deeds and mortgage statements
  • Life insurance policies
  • Social Security award letter
  • Pension benefit statements
  • Medicare card
  • Doctor's statement of care needs

Step 2: Submit Your Application

Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.

Step 3: Medical Assessment

A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.

Step 4: Financial Review

Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.

Step 5: Receive Determination

You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.

Get Free Application Help

Free Medicaid application assistance is available in Ohio from:

  • Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
  • SHIP counselors: Free Medicare/Medicaid counseling
  • Nursing facility social workers: In-facility application support
  • Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)

Ohio-Specific Programs and Resources

Medicare Savings Programs (QMB/SLMB/QI)

QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).

Learn More

MyCare Ohio (Integrated Care Delivery System)

Integrated managed care program for individuals dually eligible for Medicare and Medicaid. Coordinates medical care and long-term services through single health plan.

Learn More

PACE (Program of All-Inclusive Care for the Elderly)

Available in select Ohio counties (primarily urban areas). Comprehensive medical and social services for frail elderly age 55+.

Learn More

Need Help with Ohio Medicaid?

Contact Ohio Department of Medicaid for specific questions about eligibility, application status, or covered services.

Main Office Phone

1-800-324-8680

Application Helpline

1-800-324-8680