Medicaid long-term care in Ohio: 2026 limits, forms, and how to apply

By Bennett Dixon, founder of MedicaidChecklist · Every figure cited to an official source · Last verified 2026-07-14

Long-term-care Medicaid in Ohio — the coverage that pays for nursing-home care and, through waiver programs, care at home — runs through Ohio Medicaid Nursing Facility (Long-Term Care) coverage and PASSPORT and Assisted Living waivers (home and community-based services). It is administered by Ohio Department of Medicaid (ODM). This page collects the published 2026 rules in one place, each figure linked to its official source.

Ohio's published 2026 figures

Income limit (single applicant)

$2,982/mo

Being over this figure is not the end of the story — see the income-limit page for Ohio's published pathway.

Asset limit (single applicant)

$2,000

Countable assets only; the home (below the equity cap), one vehicle, and household goods are typically exempt.

Look-back period

60 months

Home equity cap

$752,000

Protected for a spouse at home (CSRA)

$32,532–$162,660

The community-spouse resource allowance — assets protected for a husband or wife who stays home.

Spouse-at-home income allowance

$2,705–$4,066.50/mo

Deeper dives: the Ohio income limit, the asset limit and what's exempt, and the 60-month look-back.

How to apply in Ohio

Applying is free, directly through the state. You file the application — Ohio accepts it through these channels:

Processing time: Eligibility must be determined within 45 calendar days of application, or 90 calendar days if the applicant alleges blindness or disability.

The official forms

Application for Health Coverage & Help Paying Costs (complete Appendix E for aged/blind/disabled and long-term care)(ODM 07216)

Ohio's application for health coverage; Appendix E adds the detail for aged/blind/disabled and long-term-care cases.

The main application — complete Appendix E for long-term care, per the form's instructions.

official form

Qualified Income Trust template (state-approved Miller Trust document, used when income is over the limit)(QIT template)

The state-approved Qualified Income Trust (Miller Trust) document, published by Ohio Medicaid itself.

Used when monthly income is over Ohio's special income level.

official form

Ohio Medicaid Estate Recovery acknowledgment (provided at application)(ODM 07400)

Acknowledgment that you've been informed of Ohio's estate recovery program.

Provided and signed at application.

official form

These are Ohio's own forms, linked at the source — never substitutes.

Documents caseworkers commonly request

Photo ID
Social Security number
Proof of Ohio residency
Proof of citizenship or immigration status
Proof of income (Social Security award letter, pension statements)
Bank and financial account statements covering the 60-month look-back
Property deeds and vehicle titles
Life insurance policies
Retirement account statements
Health insurance cards and premium statements
Marriage certificate (if married)
Signed Qualified Income Trust document, trust account information, and deposit verification (if income is over the limit)
Nursing facility admission information

Gathering these is most of the real work — see the full document guide for why each category matters.

Rules specific to Ohio

Qualified Income Trust (Miller Trust) required when income is over the limit

Ohio's rules provide a defined pathway for applicants whose gross monthly income is above the $2,982 special income level (2026): income deposited into a Qualified Income Trust (QIT), also called a Miller Trust, is not counted toward the limit. The trust must be irrevocable, hold only the applicant's income, and name the Ohio Department of Medicaid as remainder beneficiary at death; the signed trust document, proof of the trust bank account, and verification of monthly deposits are submitted with the application (OAC 5160:1-6-03.2). ODM publishes a free QIT template, and because a trust is a legal document, families typically have an elder-law attorney prepare or review it.

official source

Improper transfer penalty: 60-month look-back on gifts and below-value transfers

When someone applies for nursing home or waiver Medicaid, the county agency reviews all asset transfers by the applicant or spouse in the previous 60 months. Transfers for less than fair market value are presumed improper and trigger a 'restricted Medicaid coverage period' during which Medicaid will not pay for long-term care. The penalty length equals the amount transferred divided by Ohio's average private pay rate for nursing facilities, $7,787/month (effective September 1, 2024, the most recent published figure; ODM updates it every two years). Certain transfers are exempt, such as transfers to a spouse or to a blind or disabled child, and the rules include an undue-hardship process. Curing or contesting a transfer involves legal judgment, and families typically handle it with an elder-law attorney.

official source

Protections for the spouse at home (CSRA and MMMNA)

When one spouse enters a nursing home, Ohio's rules let the at-home ('community') spouse keep a protected share of the couple's countable assets: half of the assets as of the 'snapshot' date, subject to a floor of $32,532 and a ceiling of $162,660 in 2026. The community spouse may also receive part of the applicant's income if their own income is below the minimum monthly maintenance needs allowance, between $2,705 (floor effective July 1, 2026) and $4,066.50 per month under the federal standards Ohio follows. The home is exempt while the community spouse lives in it.

official source

Patient liability: most income goes to the nursing home

Once approved, a nursing-home resident's income does not stay with them. After deductions for a $75 monthly personal needs allowance (raised from $50 effective October 1, 2025), health insurance premiums, and any spousal or family allowances, the remaining monthly income is paid to the facility as 'patient liability,' and Medicaid pays the balance of the bill. Income placed in a Qualified Income Trust is included in this calculation.

official source

Home equity cap for long-term care

The home is normally an exempt asset, but Medicaid will not pay for long-term care services if the applicant's equity in the home exceeds $752,000 (2026). This cap does not apply when the applicant's spouse, child under 21, or blind or disabled child lives in the home.

official source

Estate recovery after the recipient's death

Ohio's Medicaid estate recovery program, administered by the Ohio Attorney General on behalf of ODM, seeks repayment of long-term care costs from the estate of a recipient who was permanently institutionalized or age 55 or older. Recovery is delayed while a surviving spouse is alive or while a child under 21 or a blind or disabled child survives, and heirs may request an undue-hardship waiver within 30 days of the claim notice. Applicants are informed of the program through form ODM 07400 at application.

official source

The figures on this page are Ohio's published 2026 rules, cited to the official source and last verified 2026-07-14. Eligibility decisions are made only by Ohio Department of Medicaid (ODM) — no checklist, calculator, or company can decide for it. Applying is always free through the state agency.

A note on limits of this page: whether and how any rule applies to a specific family is a question only the state agency — or an elder-law attorney — can answer. MedicaidChecklist publishes the rules and helps you prepare and organize the application; it does not give legal advice, and nothing here is a recommendation to move, transfer, or restructure money or property.

Ohio guide Ohio income limit Ohio asset limit Ohio look-back period

Sources

2026 special income level (SIL) for institutionalized/HCBS waiver individuals is $2,982/month (300% of the $994 2026 SSI federal benefit rate); 2026 spousal impoverishment standards: CSRA minimum $32,532, maximum $162,660, MMMNA cap $4,066.50; 2026 home equity limit $752,000 (ODM MEPL 191, 2026 COLA) — dam.assets.ohio.gov
Federal 2026 spousal impoverishment standards: MMMNA maximum $4,066.50; CSRA $32,532 to $162,660; minimum home equity limit $752,000 — www.medicaid.gov
MMMNA floor is $2,705/month effective July 1, 2026 through June 30, 2027 (the federal floor Ohio follows; excess shelter standard $811.50/month for the same period) — www.medicaidplanningassistance.org
A Qualified Income Trust (Miller Trust) is the mechanism for an individual with income above the SIL to become eligible for Medicaid payment of long-term care services; the trust must be irrevocable, funded only with the individual's income, name ODM as remainder beneficiary, and trust documentation must be submitted with the application (OAC 5160:1-6-03.2, effective 8/1/2016) — codes.ohio.gov
ODM publishes a free Qualified Income Trust template and Certification of Trust form for applicants over the income limit — medicaid.ohio.gov
Aged/blind/disabled Medicaid resource limit is $2,000 for an individual and $3,000 for a married couple (OAC 5160:1-3-05.1) — codes.ohio.gov
Transfers of assets for less than fair market value within the 60-month look-back period are presumed improper and result in a restricted Medicaid coverage period (OAC 5160:1-6-06) — codes.ohio.gov
The restricted Medicaid coverage period is calculated by dividing the value of improperly transferred assets by the monthly average private pay rate (APPR) for nursing facility services (OAC 5160:1-6-06.5) — codes.ohio.gov
The monthly average private pay rate (penalty divisor) is $7,787 effective September 1, 2024, updated every two years by the Scripps Gerontology Center for the Ohio Department of Aging (ODM MEPL 181) — dam.assets.ohio.gov
Patient liability calculation subtracts a personal needs allowance of $75 (plus up to $65 more from earned income), health insurance premiums, and spousal/family maintenance allowances before the remainder of income is paid to the facility (OAC 5160:1-6-07) — codes.ohio.gov
The community spouse resource allowance is the greater of one half of the couple's combined countable resources (up to the CMS maximum) or the CMS minimum, determined as of the snapshot date; the institutionalized spouse may keep $2,000 (OAC 5160:1-6-04) — codes.ohio.gov
Eligibility must be determined within 45 calendar days of application, or 90 calendar days when the individual alleges blindness or disability (OAC 5160:1-2-01) — codes.ohio.gov
Ohio's Medicaid estate recovery program recovers correctly paid benefits from the estates of permanently institutionalized individuals and individuals age 55 or older; recovery is barred while a surviving spouse or a child under 21 or blind/disabled child is alive; undue hardship waivers are available (ORC 5162.21; OAC 5160:1-2-07) — codes.ohio.gov
Form ODM 07400 informs applicants of the estate recovery program; the Ohio Attorney General's Medicaid Estate Recovery Unit presents claims to estates — dam.assets.ohio.gov
ODM 07216 Application for Health Coverage & Help Paying Costs is the current application form, amended (per MEPL 192, effective November 21, 2025) to incorporate questions for aged/blind/disabled and long-term care applicants — dam.assets.ohio.gov
The ODM 07216 application instructs aged/blind/disabled and long-term care applicants to also complete Appendix E; applications may be filed online at the Ohio Benefits portal or by calling the Medicaid Consumer Hotline at 800-324-8680 — dam.assets.ohio.gov
Cross-check: 2026 nursing home Medicaid limits for a single Ohio applicant are $2,982/month income and $2,000 in assets; a Qualified Income Trust is the pathway for applicants over the income limit; the community spouse may keep up to $162,660 — www.medicaidplanningassistance.org