Ohio-specific Medicaid spend-down rules
Ohio administers Medicaid through the Ohio Department of Medicaid (ODM). Long-term care applications start at your county Department of Job and Family Services office in places like Columbus, Cleveland, Cincinnati, Dayton, and Toledo.
Nursing facility Medicaid covers skilled nursing stays when medical necessity and asset tests pass. The PASSPORT waiver funds home care for eligible seniors who would otherwise need a nursing home, but asset tests still follow the same $2,000 resource standard for the applicant.
Ohio does not offer a medically needy income spend-down for nursing home cases the way Pennsylvania does. Families above the $2,901 monthly income cap must assign excess funds to a Qualified Income Trust, also called a Miller Trust, with an Ohio trustee.
Community spouses may keep the greater of the CSRA calculation or certain income protections under spousal impoverishment rules. The state uses the federal maximum home equity cap of $713,000 in 2026 unless a spouse or dependent child still lives in the house.
Burial spaces, one vehicle, and up to $1,500 in a designated burial fund can be excluded if titled correctly. Prepaid funeral contracts follow separate ODM policy memos in the Ohio Manual of Job and Family Services.
Look-back reviews cover asset transfers made within 60 months before application. Penalty length equals the uncompensated transfer amount divided by the average monthly nursing home cost published by ODM.
Rural applicants in Athens and Zanesville follow the same resource test as families in suburban Franklin County. PASSPORT interest lists vary by region, but the $2,000 asset cap does not.
Common mistake: Assuming Ohio exempts a second home because it is "in the family." Non-homestead real estate counts unless occupied by a spouse or dependent child under ODM rules. Budget property taxes and sale costs before you rely on an appraisal.