Navigating the complexities of Medicaid eligibility can be daunting, especially when it comes to understanding income limits. What Is The Medicaid Income Limit In Ohio? It’s a critical question for seniors and individuals with disabilities seeking long-term care and assistance. At income-partners.net, we are committed to providing you with clear, concise information about Medicaid eligibility in Ohio, helping you explore partnership opportunities for financial growth and security. Let’s delve into the details of Ohio Medicaid’s income limits and how you can qualify, even if you exceed those limits, so you can secure the care and support you need while discovering ways to increase your income through strategic partnerships. We’ll also explore various Medicaid programs, eligibility criteria, asset limits, and strategies to navigate the complexities of Medicaid planning and eligibility.
1. Understanding Ohio Medicaid Long-Term Care
Medicaid provides healthcare coverage for individuals across all age groups with lower incomes. While Medicaid encompasses various coverage options, our focus is on long-term care solutions for Ohio residents aged 65 and older. Beyond covering care in nursing homes and assisted living facilities, Ohio Medicaid extends its support to non-medical services, enabling seniors to maintain their independence in their own homes. There are primarily three distinct categories of Medicaid long-term care programs available to Ohio seniors.
- Institutional / Nursing Home Medicaid: This is an entitlement program, ensuring that anyone who meets the eligibility requirements will receive assistance. However, benefits are exclusively provided within nursing home facilities.
- Medicaid Waivers / Home and Community Based Services (HCBS): Unlike the entitlement nature of Nursing Home Medicaid, HCBS waivers have a limited number of participants, which may result in waitlists. These waivers aim to prevent or delay nursing home admissions by offering services in various settings, including homes, adult day care centers, or assisted living facilities.
- Regular Medicaid / Aged, Blind, or Disabled (ABD): As an entitlement program, meeting the eligibility criteria ensures assistance will be provided. Various long-term care benefits, such as personal care assistance or adult day care, may be available.
While funding for Medicaid comes from both the state and federal government, its administration is handled by the state according to federal guidelines. In Ohio, the Ohio Department of Medicaid (ODM) is responsible for overseeing the program.
The American Council on Aging offers a free, quick and easy Medicaid Eligibility Test for seniors, allowing individuals to assess their potential eligibility for Medicaid benefits.
Image: Home health aide assisting a senior woman with daily tasks, highlighting the importance of Medicaid in providing care and support for Ohio’s elderly population.
2. Income and Asset Limits for Ohio Medicaid Eligibility
Navigating the financial requirements for Medicaid eligibility can be complex, as each of the three long-term care categories has its own set of financial and medical criteria. These requirements can change annually, vary based on marital status, and offer alternative eligibility pathways.
Simplified Eligibility Criteria: Single Nursing Home Applicant
In 2025, a single Nursing Home Medicaid applicant must generally meet the following criteria:
- Income under $2,901 / month
- Assets under $2,000
- Require a Nursing Home Level of Care
The table below offers a quick reference to help seniors determine their immediate eligibility for long-term care through Ohio Medicaid programs. However, it’s important to remember that not meeting all criteria doesn’t automatically disqualify someone from Medicaid eligibility.
| 2025 Ohio Medicaid Long-Term Care Eligibility for Seniors | |
|---|---|
| Type of Medicaid | |
| Single | |
| Income Limit | |
| Institutional / Nursing Home Medicaid | |
| $2,901 / month* | |
| Medicaid Waivers / Home and Community Based Services | |
| $2,901 / month† | |
| Regular Medicaid / Aged Blind and Disabled | |
| $967 / month | |
| Married (both spouses applying) | |
| Income Limit | |
| Institutional / Nursing Home Medicaid | |
| $5,802 / month* | |
| Medicaid Waivers / Home and Community Based Services | |
| $5,802 / month† | |
| Regular Medicaid / Aged Blind and Disabled | |
| $1,450 / month | |
| Married (one spouse applying) | |
| Income Limit | |
| Institutional / Nursing Home Medicaid | |
| Medicaid Waivers / Home and Community Based Services | |
| Regular Medicaid / Aged Blind and Disabled | |
| $1,450 / month |
*All of a beneficiary’s monthly income, with the exception of a Personal Needs Allowance of $50 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse (if applicable), 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 keep monthly income up to this level. In Ohio, persons who are found eligible for SSI are automatically approved for Medicaid.
2.1. What income is considered for Medicaid eligibility in Ohio?
For Medicaid eligibility in Ohio, almost all income received by an applicant counts towards the income limit, including wages, alimony, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. However, Veteran’s Aid & Attendance, exceeding the Basic VA Pension, and Holocaust restitution payments are exempt.
2.2. How is income treated for married couples when one spouse applies for Medicaid in Ohio?
When only one spouse applies for Nursing Home Medicaid or a Medicaid Waiver in Ohio, only the applicant’s income is counted. The non-applicant spouse’s income is disregarded. The non-applicant spouse may also be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse to prevent impoverishment.
In Ohio, the MMMNA is $2,643.75 (eff. 7/1/25 – 6/30/26). If the non-applicant spouse’s monthly income is below this, income can be transferred from the applicant spouse to reach this level. If housing and utility costs exceed a “shelter standard” of $793.13 / month (eff. 7/1/25 – 6/30/26), the non-applicant spouse can further increase their income allowance. However, the Spousal Income Allowance cannot push the non-applicant’s monthly income over $3,948 in 2025, which is the Maximum Monthly Maintenance Needs Allowance.
When only one spouse applies for Regular Medicaid, the income of both spouses is calculated towards the applicant’s eligibility, and there is no Monthly Maintenance Needs Allowance for the non-applicant spouse.
2.3. What assets are considered countable for Ohio Medicaid eligibility?
Countable assets for Ohio Medicaid eligibility include cash, stocks, bonds, investments, bank accounts, and non-primary residence real estate. Exempt assets include personal belongings, household furnishings, an automobile, and irrevocable burial trusts. IRAs / 401Ks in “payout status” are also exempt, as is one’s primary home.
2.4. How are assets treated for married couples when one spouse applies for Medicaid in Ohio?
For married couples, all assets are considered jointly owned, regardless of the Medicaid program. The non-applicant spouse of a Medicaid Nursing Home or Waiver applicant is permitted a Community Spouse Resource Allowance (CSRA). In 2025, the community spouse can retain 50% of the couples’ assets, up to a maximum of $157,920. If the non-applicant’s half of the assets falls under $31,584, they can retain 100% of the couple’s assets, up to $31,584. Note that there is no CSRA for Regular Medicaid.
Image: An older couple discussing financial planning, emphasizing the importance of understanding Medicaid asset rules and community spouse resource allowance.
2.5. What is the Medicaid Look-Back Period in Ohio?
Ohio has a 5-year Medicaid Look-Back Period preceding Nursing Home Medicaid or Medicaid Waiver applications. During this period, Medicaid reviews all asset transfers to ensure no assets were gifted or sold under fair market value to meet Medicaid’s asset limit. Violations result in a period of Medicaid ineligibility. The Look-Back Period does not apply to Regular Medicaid.
It’s important to note that the IRS Gift Tax Exemption does not extend to Medicaid eligibility, and gifting under this exemption violates Medicaid’s Look-Back Period.
3. Defining Income for Ohio Medicaid
Understanding what constitutes income for Medicaid eligibility is crucial. Almost all income received by a Medicaid applicant is factored into the income limit. This includes various sources, such as employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. However, certain types of income are exempt from consideration. Nationally, Holocaust restitution payments are excluded from income calculations. Additionally, in Ohio, the Veteran’s Aid & Attendance benefit, which supplements the Basic VA Pension, is also disregarded as income.
3.1. How Ohio Medicaid Treats Income for Married Couples
When only one spouse in a married couple applies for Nursing Home Medicaid or a Medicaid Waiver, only the applicant’s income is taken into account. The income of the non-applicant spouse is not considered. Furthermore, the non-applicant spouse, also known as the community spouse, may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse. The MMMNA is designed to ensure that the non-applicant spouse has sufficient income to avoid spousal impoverishment.
In Ohio, the MMMNA is set at $2,643.75 (effective from July 1, 2025, to June 30, 2026). If the non-applicant spouse’s monthly income falls below this amount, income can be transferred from the applicant spouse to bring their income up to $2,643.75. Additionally, the non-applicant spouse can further increase their income allowance if their housing and utility costs exceed a “shelter standard” of $793.13 per month (effective from July 1, 2025, to June 30, 2026). However, in 2025, a Spousal Income Allowance cannot exceed $3,948 per month, which is the Maximum Monthly Maintenance Needs Allowance.
It’s important to note that income is treated differently when only one spouse applies for Regular Medicaid. In such cases, the income of both spouses is calculated to determine the applicant’s income eligibility. Unlike Nursing Home Medicaid or Medicaid Waiver programs, there is no Monthly Maintenance Needs Allowance for the non-applicant spouse.
4. Defining Assets for Ohio Medicaid
4.1. Countable vs. Non-Countable Assets
When determining Medicaid eligibility, it’s essential to understand the distinction between countable and non-countable assets. Countable assets are those that are considered when assessing an applicant’s financial resources and are calculated towards Medicaid’s asset limit. These typically include:
- Cash
- Stocks
- Bonds
- Investments
- Bank accounts (including credit union, savings, and checking accounts)
- Real estate in which one does not reside
On the other hand, Medicaid recognizes certain assets as exempt or non-countable, meaning they are not factored into the asset limit. These exemptions include:
- Personal belongings
- Household furnishings
- An automobile
- Irrevocable burial trusts
- In Ohio, IRAs / 401Ks in “payout status” are exempt, meaning that Required Minimum Distributions (RMDs) are being withdrawn.
- One’s primary home is generally exempt, subject to certain conditions.
4.2. How Ohio Medicaid Treats Assets for Married Couples
For married couples, Medicaid considers all assets to be jointly owned, regardless of the specific long-term care Medicaid program for which one or both spouses are applying. However, there is an exception for the non-applicant spouse of a Medicaid Nursing Home or Waiver applicant, who is permitted a Community Spouse Resource Allowance (CSRA).
In 2025, the community spouse (the non-applicant spouse) can retain 50% of the couple’s assets, up to a maximum of $157,920. This provision ensures that the community spouse has access to a certain level of financial resources to maintain their standard of living.
If the non-applicant’s half of the assets falls under $31,584, the non-applicant spouse can retain 100% of the couple’s assets, up to $31,584. This ensures that even couples with limited assets have some protection.
It’s important to note that the Community Spouse Resource Allowance (CSRA) does not apply to Regular Medicaid.
4.3. Ohio Medicaid’s Look-Back Rule
Ohio, like many other states, has a Medicaid Look-Back Period in place. This is a period of time, specifically 5 years, that immediately precedes one’s date of application for Nursing Home Medicaid or a Medicaid Waiver. During this “look back” period, Medicaid scrutinizes all asset transfers made by the applicant to ensure that no assets were gifted or sold below fair market value.
The purpose of this rule is to prevent individuals from deliberately transferring assets to become eligible for Medicaid while still retaining control or benefit from those assets. If Medicaid determines that assets were transferred in violation of the Look-Back Rule, the applicant may be penalized with a period of Medicaid ineligibility.
It’s important to note that the Look-Back Period does not apply to Regular Medicaid.
Furthermore, the IRS Gift Tax Exemption does not extend to Medicaid eligibility. This means that even if a gift is within the allowable limit for gift tax purposes, it may still be considered a violation of Medicaid’s Look-Back Period.
Image: Elderly woman sitting in a wheelchair in her living room, illustrating the role of Medicaid in supporting long-term care and community-based services.
5. Ohio Medicaid Home Exemption Rules
When determining Medicaid eligibility in Ohio, the treatment of one’s home is a significant consideration. Here are the key rules regarding home exemption:
- Occupancy Requirement: To qualify for home exemption, the Medicaid applicant or their spouse must reside in the home. If neither the applicant nor their spouse lives in the home, the applicant must demonstrate Intent to Return.
- Home Equity Interest Limit: If there is no spouse residing in the home, there is a home equity interest limit of $730,000 in 2025. Home equity is calculated as the value of the home minus any outstanding debt against it, and equity interest refers to the portion of the home’s equity owned by the applicant.
- Regular Medicaid Exception: It’s important to note that there is no home equity interest limit for Regular Medicaid.
While a home is generally exempt from Medicaid’s asset limit, it’s not exempt from Medicaid’s Estate Recovery Program. Following a long-term care Medicaid beneficiary’s death, Ohio’s Medicaid agency may attempt to recover the costs of care provided through the beneficiary’s estate, which often includes the home. Without proper planning strategies, the home may be used to reimburse Medicaid for care expenses rather than being passed on to family members as inheritance.
6. Ohio Medicaid Medical / Functional Need Requirements
In addition to meeting financial criteria, applicants must demonstrate a medical need for long-term care Medicaid. For Nursing Home Medicaid and Medicaid Waivers, a Nursing Facility Level of Care (NFLOC) is required. Some program benefits may have additional requirements, such as the need for home modifications to ensure safe living conditions. For long-term care services through Regular Medicaid, a functional need involving Activities of Daily Living (ADLs) is necessary, but a Nursing Facility Level of Care may not be required.
7. Qualifying for Ohio Medicaid When Over the Limits
Even if you exceed the financial eligibility requirements for Ohio Medicaid, there are still avenues to explore for qualification:
- Qualified Income Trusts (QITs): Also known as Miller Trusts, QITs allow individuals with income exceeding Medicaid’s limit to become income-eligible for Nursing Home Medicaid or a Medicaid Waiver. By depositing “excess” income into the trust, it is not counted towards Medicaid’s income limit. The trust must be irrevocable, and a trustee manages the funds for specific purposes, such as paying medical expenses.
- Asset Spend Down: Individuals with countable assets above Ohio Medicaid’s asset limit can “spend down” those assets on non-countable items or expenses to become asset-eligible. This can include home modifications, prepaying funeral and burial expenses, and paying off debt. However, gifting assets or selling them below fair market value within 60 months of applying for Nursing Home Medicaid or a Medicaid Waiver is prohibited due to Medicaid’s Look-Back Rule.
- Medicaid Planning: For individuals who are “over-income” or “over-asset” but cannot afford their cost of care, Medicaid planning offers a solution. By working with a Medicaid Planning Professional, families can utilize various strategies to become Medicaid-eligible and protect their primary home from Medicaid’s Estate Recovery Program.
At income-partners.net, we understand the complexities of Medicaid eligibility and offer resources to help you navigate these challenges and explore partnership opportunities for financial growth and security.
Image: A woman meeting with a financial advisor, illustrating the importance of Medicaid planning in navigating eligibility and protecting assets.
8. Specific Ohio Medicaid Programs for Long-Term Care
In addition to nursing home care, Ohio Medicaid provides various programs to support seniors in their homes and communities:
- PASSPORT Waiver: Formally known as Pre-Admission Screening System Providing Options & Resources Today, PASSPORT offers a range of long-term services and supports, including adult day care, home care, home modifications, and medical equipment/supplies.
- Assisted Living Waiver: This program assists individuals aged 21 and older in living in residential care facilities and assisted living residences. While it does not cover room and board, it pays for care services. Note that not all Ohio assisted living residences accept waiver participants.
- MyCare Ohio: This is a mandatory managed care Medicaid program in 29 Ohio counties for individuals dually eligible for Medicaid and Medicare. Benefits may include adult day care, assisted living services, memory care services, home modifications, meal delivery, personal emergency response systems, and more.
- Program of All-Inclusive Care for the Elderly (PACE): PACE combines the benefits of Medicaid, including long-term care, and Medicare into a single program, with additional benefits like dental and eye care potentially available.
- Money Follows the Person (MFP): Also known as HOME Choice in Ohio, this federal program helps institutionalized individuals eligible for Medicaid transition back home or into the community.
9. How to Apply for Ohio Medicaid
Seniors can apply for long-term care Medicaid in Ohio through various channels:
- Online at Ohio Benefits
- Via the Consumer Hotline at 1-800-324-8680
- In person at one’s county Job and Family Services office
One’s local Area Agency on Aging office may also provide assistance with Medicaid program-related questions and application support. The application process may vary depending on the specific program being applied for.
Prior to applying, it’s crucial to ensure that all eligibility requirements are met. For seniors with income or assets exceeding the limits, Medicaid planning is strongly recommended. The application process can be complex, requiring the inclusion of detailed documentation. Familiarizing oneself with general information about the application process for long-term care Medicaid can be beneficial.
10. Ohio Medicaid FAQs
10.1. What is the income limit for Ohio Medicaid in 2025?
The income limit for Ohio Medicaid in 2025 varies depending on the specific program and marital status. For single applicants, the income limit for Institutional/Nursing Home Medicaid and Medicaid Waivers is generally $2,901 per month. For Regular Medicaid, the income limit for a single applicant is $967 per month.
10.2. What assets are exempt from Ohio Medicaid?
Exempt assets for Ohio Medicaid include personal belongings, household furnishings, an automobile, irrevocable burial trusts, and, in some cases, IRAs/401(k)s in “payout status”. One’s primary home is also generally exempt, subject to certain conditions.
10.3. Can I qualify for Ohio Medicaid if my income is too high?
Yes, even if your income exceeds the standard limits, you may still qualify for Ohio Medicaid through strategies like Qualified Income Trusts (QITs), also known as Miller Trusts. These trusts allow you to deposit excess income, effectively reducing your countable income for Medicaid eligibility purposes.
10.4. What is the Community Spouse Resource Allowance (CSRA) in Ohio?
The Community Spouse Resource Allowance (CSRA) allows the non-applicant spouse of a Medicaid Nursing Home or Waiver applicant to retain a portion of the couple’s assets. In 2025, the community spouse can retain 50% of the couple’s assets, up to a maximum of $157,920.
10.5. What is the Medicaid Look-Back Period in Ohio, and how does it affect eligibility?
Ohio has a 5-year Medicaid Look-Back Period, during which Medicaid reviews asset transfers to ensure no assets were gifted or sold below fair market value to meet Medicaid’s asset limit. Violations can result in a period of Medicaid ineligibility.
10.6. Does Ohio Medicaid pay for assisted living?
While Ohio Medicaid doesn’t directly pay for room and board in assisted living facilities, the Assisted Living Waiver program can help cover the cost of care services provided in participating assisted living residences.
10.7. How does Ohio Medicaid’s Estate Recovery Program work?
Following a long-term care Medicaid beneficiary’s death, Ohio’s Medicaid agency may attempt to recover the costs of care provided through the beneficiary’s estate, which often includes the home.
10.8. What is the PASSPORT Waiver in Ohio?
The PASSPORT Waiver, formally known as Pre-Admission Screening System Providing Options & Resources Today, provides a range of long-term services and supports, including adult day care, home care, home modifications, and medical equipment/supplies, to eligible Ohio residents.
10.9. Where can I find more information about Ohio Medicaid and long-term care options?
You can find more information about Ohio Medicaid and long-term care options at the Ohio Department of Medicaid website, your local Area Agency on Aging office, or by contacting a Medicaid planning professional.
10.10. How can income-partners.net assist with Medicaid planning and financial strategies?
At income-partners.net, we offer resources and guidance to help you navigate the complexities of Medicaid eligibility, explore partnership opportunities for financial growth, and develop strategies to secure the care and support you need. We understand the importance of financial stability and can connect you with potential partners to help you achieve your income goals.
Navigating the intricacies of Medicaid eligibility in Ohio can be challenging, but with the right information and resources, you can access the care and support you need. At income-partners.net, we’re dedicated to providing you with clear, comprehensive guidance and connecting you with opportunities to enhance your financial well-being.
Ready to take the next step? Visit income-partners.net today to explore our resources, discover partnership opportunities, and connect with professionals who can help you navigate the complexities of Medicaid planning and financial strategies in Ohio. Don’t wait – your path to financial security and access to quality care starts now!
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