Ohio Medicaid for Seniors & Long-Term Care

The PASSPORT waiver is Ohio's primary Home and Community-Based Services (HCBS) waiver for seniors and adults with disabilities who meet nursing facility level of care. Under Section 1915(c) of the Social Security Act, PASSPORT allows Ohio to provide services at home that would otherwise require institutional care. The program is administered through a network of Area Agencies on Aging (AAA) across Ohio's 88 counties.

PASSPORT remains the primary waiver for seniors who have Medicaid only. Members who are also enrolled in Medicare (dual eligibles) and are eligible for Next Generation MyCare now receive their HCBS waiver benefits through the MyCare Ohio Waiver instead of PASSPORT — see the Next Generation MyCare section below for details on this 2026 change.

PASSPORT has a waitlist in some areas. Applicants who qualify medically may wait weeks to months depending on county and available funding slots — being on the waitlist does not guarantee enrollment. Contact your local AAA for current wait times.

MyCare Ohio is Ohio's integrated care program for people enrolled in both Medicare and Medicaid — called dual eligibles — and it coordinates medical care, behavioral health, and long-term services and supports through a single managed care plan, so members have one plan and one care coordinator managing both Medicare and Medicaid benefits.

Ohio Medicaid rolled out an upgraded "Next Generation MyCare" program in 2026: Phase 1 began January 1, 2026 in the 29 counties that already had MyCare Ohio, and Phase 2 expanded the program to the rest of the state between April and August 2026. As of this writing, Next Generation MyCare is available statewide — it is no longer limited to 29 counties. The Next Generation MyCare plans are Anthem, Buckeye Health Plan, and CareSource; Aetna Better Health of Ohio and UnitedHealthcare Community Plan are no longer part of MyCare Ohio as of January 1, 2026.

As part of this transition, members who were enrolled in the Ohio Home Care Waiver, Assisted Living Waiver, or PASSPORT waiver and who are also eligible for MyCare Ohio joined a single consolidated "MyCare Ohio Waiver" on January 1, 2026 (or on their county's Phase 2 start date). Per the Ohio Department of Medicaid, members keep the same benefits, or more, under the MyCare Ohio Waiver. Dual eligibles who are not enrolled in MyCare Ohio, or who are enrolled in a PACE program or a developmental disabilities waiver, are not affected by this change.

Ohio Medicaid covers nursing facility care for enrollees who meet both a medical level-of-care standard and the financial eligibility rules described above. Financial rules for nursing facility Medicaid are separate from the MAGI-based rules for standard adult coverage — countable resources must be at or below $2,000, and countable resources include bank accounts, investments, and most personal property.

Federal spousal impoverishment rules under 42 U.S.C. § 1396r-5 protect the spouse who remains at home (the "community spouse") from having to give up all marital assets to get the nursing facility spouse onto Medicaid. Ohio applies these rules — the community spouse can retain half of the couple's countable assets at the time of the Medicaid application, up to the federal maximum Community Spouse Resource Allowance (CSRA), and is protected from having to contribute their own income to the nursing facility spouse's care through a Monthly Maintenance Needs Allowance (MMNA) calculation.

Per the Ohio Department of Medicaid, Ohio recovers Medicaid costs from the estates of deceased recipients who were age 55 or older when they received nursing facility care, PASSPORT waiver services, or other long-term care services. Recovery may extend to liens on real property in certain situations. The home is generally protected while a surviving spouse, minor child, or disabled child lives there, but becomes subject to recovery after they vacate or pass away. An elder law attorney can help structure assets and plan around estate recovery legally.