To qualify for Ohio Medicaid long-term care, a single applicant's countable resources must fall to $2,000, or $3,000 when both spouses apply. That resource test is one of the gates Medicaid applies, alongside a separate income cap and a level-of-care finding. The fear behind that search is that the nursing home will take everything, but most of what a family owns (the home, a car, household goods, certain burial and life-insurance arrangements) never counts in the first place. Asset spend-down is the work of converting countable dollars into exempt assets and full-value purchases, not going broke. This guide covers Ohio's exact 2026 limits, the assets you keep, the lawful ways to spend down, and the gifts that trigger a five-year penalty.

In This Guide

How Low Is Ohio's Asset Limit?

To start Ohio Medicaid long-term care, a single applicant's countable resources must fall to $2,000, and a married couple with both spouses applying must reach $3,000. These are the SSI-aligned figures the Ohio Department of Medicaid (ODM) publishes on its 2026 Medicaid Standards Help Sheet, and they match the federal Supplemental Security Income (SSI) resource limits of $2,000 for an individual and $3,000 for a couple.,

The limit governs every long-term-care pathway: a nursing-facility stay, the PASSPORT waiver, the Assisted Living Waiver, and the Ohio Home Care Waiver. It applies the same way to long-term-care services delivered through Next Generation MyCare, Ohio's integrated managed-care program for people who have both full Medicaid and Medicare, which replaced MyCare Ohio on January 1, 2026 and is rolling out statewide through August 1, 2026. The figure that matters is countable resources on the eligibility date, not a family's net worth. Many families hear "$2,000" and assume they must end up with $2,000 to their name; the rule is narrower, because a large share of what most households own is exempt and never counts.

What "Countable" Means

A countable resource is an asset the applicant owns, can convert to cash, has a value above zero, and that no specific exemption covers. The county Department of Job and Family Services (CDJFS) values each countable asset at its fair market value on the eligibility date and verifies it through bank, investment, and retirement statements, real estate valuations, vehicle titles, and life-insurance declarations. Bank statements are requested across the full 60-month look-back window for a long-term-care application.

Income Is a Second, Separate Gate

Ohio is an income-cap state for institutional and waiver long-term care. An applicant whose countable monthly income exceeds the special income level (SIL), set at 300% of the SSI federal benefit rate, or $2,982 a month for 2026, may establish a Qualified Income Trust (a Miller Trust) under Ohio Administrative Code (OAC) 5160:1-6-03.2 to bring countable income back under it. Ohio's own rule says "may," not "must," so ask your caseworker what else fits before assuming the trust is the only door. Two conditions ride with the SIL. Only someone institutionalized for a continuous period may be tested against it (OAC 5160:1-6-03.1(D)), and clearing it does not erase patient liability: the applicant still owes a calculated share of income to the facility. Asset spend-down reduces resources; the Miller Trust manages income.,

What Assets Can You Keep?

Ohio mostly mirrors the federal SSI exempt-resource rules. None of the categories below count toward the resource limit.

The Home

The primary residence is exempt up to a home-equity cap. Federal law sets that cap as a range indexed each year to the Consumer Price Index under 42 U.S.C. 1396p(f); for 2026 it is a federal minimum of $752,000, which a state may elect to raise to no more than $1,130,000. Ohio applies the federal minimum, so the 2026 Ohio home-equity limit is $752,000.,

The equity cap is waived entirely when a spouse, or a minor or disabled child, lives in the home. That is a complete disapplication of the equity test, not a bigger number. Two other situations preserve the home's exemption while the applicant is in a facility, which is a different question from the equity cap: a sibling co-owner who occupied the home for at least a year before institutionalization, and an applicant who signs a statement of intent to return home. Neither of those lifts the equity cap. But being over the cap is not a permanent bar either. The same statute says nothing in it prevents an applicant from using a reverse mortgage or a home equity loan to bring equity below the limit, and the Secretary must maintain a process for waiving the limit in a demonstrated hardship. One change is on the calendar: beginning January 1, 2028, federal law caps the home-equity limit for non-agricultural homes at a flat $1,000,000 regardless of inflation indexing. That amendment reaches the dollar limit alone, so the spouse-and-child waiver, the reverse-mortgage route, and the hardship process all survive it.

One Vehicle, Household Goods, and Personal Effects

One automobile of any value is exempt; a second vehicle counts at fair market value. Furniture, appliances, clothing, personal jewelry, and similar household and personal effects are exempt, though collectibles held for investment (rare coins, art, antique cars) can be counted. Ohio follows SSI on these categories; confirm any borderline item with your CDJFS.

Burial and Funeral Arrangements

Burial spaces are exempt under a separate SSI exclusion, in addition to the burial fund below. A burial fund is exempt up to $1,500 for the applicant and a separate $1,500 for a spouse, but only if kept separate from other resources and clearly designated for burial; mix it in with other money and none of it is excluded. That $1,500 is not a free-standing amount. It is reduced by three things: the face value of any life insurance on that person whose cash surrender value is already excluded, any irrevocable burial arrangement or trust, and (the reducer families miss) burial insurance, along with any life policy naming a funeral provider as irrevocable beneficiary. Burial insurance carries no cash surrender value, so the first reducer never reaches it; a $1,200 final-expense policy still cuts the available $1,500 to $300. A family holding both a small whole-life policy and a prepaid arrangement may have none of it left. The figure is fixed by regulation and is not indexed to inflation.

An irrevocable prepaid funeral contract with a licensed funeral home is exempt without a dollar limit when the funds are held by the funeral home or in an irrevocable trust. A revocable funeral contract counts at its cash value.

Life Insurance

Whole and universal policies count at their cash surrender value, with one exception: if the total face value of all policies on any one insured person is $1,500 or less, their cash surrender value is entirely excluded. Once the total face value goes above $1,500, the combined cash surrender value of the policies counts. Term insurance and burial insurance are left out of that face-value total. This is the federal SSI threshold rather than an Ohio-specific number, and like the burial-fund figure it is fixed by regulation and not indexed to inflation.

Retirement Accounts and Special Needs Trusts

How Ohio treats an IRA, 401(k), or pension turns on whether the account is in pay status, and no rule we can cite settles it. Do not assume an account is exempt; have an elder-law attorney confirm before you plan around it.

Assets in a properly drafted special needs trust can be exempt, but the drafting decides it. A first-party trust under 42 U.S.C. 1396p(d)(4)(A) holds the assets of a disabled person under age 65; its payback clause must reach whichever State or States paid rather than Ohio by name, must put them first in line ahead of other debts and administrative expenses, and cannot cap payback at a set number of years. A pooled trust under 42 U.S.C. 1396p(d)(4)(C) is nonprofit-managed and the statute sets no age cap, but age bites from the other side: the Social Security Administration warns that funding a pooled-trust account for someone 65 or older may itself trigger a transfer penalty, because the transfer exception at 1396p(c)(2)(B)(iv) reaches only trusts for a person under 65. Either trust must be for the sole benefit of the disabled person; a clause paying anyone else during their lifetime voids the exception.

How Do You Lawfully Spend Down?

A lawful spend-down either converts countable cash into an exempt asset or buys the applicant full value (goods, care, or services). Either way, the applicant receives fair market value, so no transfer penalty applies under Ohio's improper-transfer rule, OAC 5160:1-6-06.

  • Pay off the mortgage and improve the home. Paying down mortgage principal converts countable cash into exempt home equity, within the equity cap. Capital improvements (roof, HVAC, plumbing) and accessibility work (ramps, grab bars, a walk-in shower, a stair lift) increase the value of an exempt asset.
  • Prepay a funeral and set aside burial funds. An irrevocable prepaid funeral contract and a designated burial fund convert a meaningful amount of countable cash into guaranteed arrangements. This is one of the most-used Ohio strategies.
  • Upgrade the one exempt vehicle. Selling an older car and buying a newer, more reliable one (including a wheelchair-accessible van) keeps the conversion inside the one-vehicle exemption.
  • Replace worn household and personal items. Replacing furniture, appliances, or clothing for personal use is a valid conversion.
  • Pay the applicant's own debts and care costs. Paying off the applicant's mortgage, credit cards, taxes, and medical bills at fair market value, and prepaying medical, dental, or vision care that will actually be delivered, all reduce countable resources.
  • Pay reasonable Medicaid-planning attorney fees. The applicant receives legal services in exchange for payment.
  • Use a personal services contract for family caregiving. Paying a family caregiver is lawful only under a written contract executed before services begin, at a reasonable documented rate with proper tax treatment. Have an attorney draft it; without a written contract, payments to family are presumed gifts.

What Spending Triggers a Penalty?

Some spending does not reduce countable resources because it delivers value to someone other than the applicant. Under Ohio's transfer rule, when an applicant or spouse disposes of assets for less than fair market value on or after the 60-month look-back date, the transfer is presumed improper and creates a penalty period during which Medicaid will not pay for long-term care.

The penalty length is the transferred value divided by Ohio's Average Monthly Private Pay Rate (APPR) for nursing-facility care, which ODM sets at $7,787 a month, effective September 1, 2024 and still the operative figure in the 2026 Standards Help Sheet. OAC 5160:1-6-06.5 prorates a partial first month by dividing the monthly APPR by the days in that month. The penalty begins on the later of the transfer date or the date the applicant is otherwise eligible and receiving institutional-level care, and an undue-hardship waiver is available under federal law when the penalty would deprive the applicant of necessary care.,

These moves are transfers, not spend-down:

  • Gifting cash or assets to children, grandchildren, or friends, including small annual gifts. The IRS gift exclusion is irrelevant to Medicaid; any uncompensated transfer in the look-back is a penalty event.
  • Selling property to family below fair market value (the discount is the transfer).
  • Adding a non-spouse to a deed, or forgiving a debt owed to the applicant.
  • Paying off a relative's debt or buying assets titled to a non-spouse family member.
  • Paying family for care without a written personal services contract.
  • Purchasing a non-compliant annuity, or funding most irrevocable trusts within the look-back.
  • Large charitable donations beyond the applicant's established lifetime pattern.

The presumption is not the whole rule, and the exceptions are load-bearing. OAC 5160:1-6-06(D) lists seven transfers Ohio does not treat as improper, including transfer of the home title to a spouse, to a child under 21 or a blind or disabled child, to a caretaker child who lived there two years and whose care kept the applicant out of a facility, or to a sibling with an equity interest who lived there a year; assets moved to or from a spouse, or to a trust for the sole benefit of a disabled child or of any disabled person under 65; and income moved into a qualified income trust. A transfer can also be rebutted, and returning all of the transferred assets removes the penalty (a partial return does not).

A purchased annuity is tested by two separate federal provisions, not one checklist. Under 42 U.S.C. 1396p(c)(1)(F) the purchase counts as a transfer for less than fair market value unless the state is named remainder beneficiary, either in first position for at least the total Medicaid paid or in second position behind a community spouse or a minor or disabled child. That second option matters: a couple who names the state ahead of the healthy at-home spouse, believing first position is mandatory, sends the remainder to Ohio instead of to the survivor. Under 1396p(c)(1)(G) the annuity is separately a countable asset unless it is a retirement annuity (an IRC 408(b) or (q) contract, or one bought with IRA, SEP, or Roth proceeds) or it is irrevocable and nonassignable, actuarially sound, and pays equal amounts with no deferral or balloon. Those two are alternatives, but neither excuses naming the state.

Ohio Medicaid Asset Spend-Down vs. ABD Pay-In Spend-Down

Families routinely confuse two different things, and one of them no longer exists in Ohio. The one-time asset spend-down described on this page is current: it qualifies a long-term-care applicant by reducing countable resources to the limit. A monthly income spend-down is different, and Ohio ended it. The Ohio Department of Medicaid states that "When Ohio becomes a 1634 state on August 1, 2016, individuals will no longer be able to spenddown to become eligible for Medicaid," so an aged, blind, or disabled applicant whose income is too high cannot buy in month by month. For long-term care above the income cap the usual route is a Miller Trust, not an income spend-down.

Feature Asset spend-down (this guide) ABD pay-in spend-down
Who it serves Long-term-care applicants (nursing facility and HCBS waivers) Aged, blind, or disabled people in the community with income over the limit
What it reduces Countable resources, down to the asset limit Countable income each month, down to the need standard
Look-back applies Yes, the federal 60-month look-back No
Timing One-time, at application Monthly
Income rule Income managed separately through a Miller Trust if over the SIL Pay the excess (or show medical expenses) each month

The common error is assuming a long-term-care applicant can simply "pay in" each month; ODM's letter closed that route in 2016, so plan on a one-time asset spend-down instead. No page we read establishes an ABD spend-down still operating after that date, but an absence is not something a page can prove, so confirm current policy with your CDJFS before you rule it out.

How Does Spend-Down Work for a Married Couple?

When one spouse enters care and the other stays in the community, Ohio uses the federal spousal-impoverishment framework, and the order of operations matters.

1
Step 1

Snapshot

ODM takes a resource snapshot of all marital countable assets as of the first day of the institutionalized spouse's continuous institutionalization (or the waiver application date).

2
Step 2

Community Spouse Resource Allowance (CSRA)

The community spouse keeps a share of the snapshot total, bounded by the 2026 federal band of $32,532 to $162,660.

3
Step 3

Spend-down

The institutionalized spouse must still reach the $2,000 applicant limit; the couple spends down everything above the protected CSRA plus that limit.,

4
Step 4

Income

A community spouse with low income can keep a monthly maintenance needs allowance between $2,705.00 and $4,066.50 for 2026, drawn from the institutionalized spouse's income.

Spend-down occurs after the snapshot and does not change the CSRA, so married couples should sequence the snapshot before spending. See the spousal impoverishment guide for the full mechanic.

How Ohio Medicaid Asset Spend-Down Affects Estate Recovery

Planning does not end at eligibility. Ohio elects expanded Medicaid estate recovery, reaching both probate and non-probate assets (joint tenancy, survivorship, life estate, living trust, and similar) for recipients 55 or older or permanently institutionalized, in the amount of all benefits correctly paid. That is broader than the probate-only floor federal law has required of every state since 1993.,

Because recovery reaches non-probate transfers, an Ohio transfer-on-death deed does not by itself shield the home. Spend-down moves that build home equity or fund a prepaid funeral interact with this aggressive recovery, so the planning horizon runs past the eligibility date. Recovery is deferred while a surviving spouse is alive or a surviving child is under 21, blind, or permanently and totally disabled. See the estate recovery guide for the protections and the claim process.

When DIY Spend-Down Is Plausible

Self-directed spend-down can work for the simplest cases: a single applicant, modest countable resources, no real estate beyond the home, no sizable retirement accounts, no significant gifts in the past five years, and no business interests or trusts. For everything else, an elder-law attorney is worth the fee, which is itself a lawful spend-down. The penalty math is unforgiving: a wrong move during the 60-month look-back can cost a family months of private-pay nursing-facility bills.

A clean spend-down works down the list above (debts, prepaid funeral, burial fund, home repairs, prepaid dental and vision, replacements, attorney fees) until countable resources reach the limit. The opposite move, gifting cash to children or paying a grandchild's tuition, converts an immediate qualification into a penalty period the family funds out of pocket.

Frequently Asked Questions

What is the Ohio Medicaid asset limit in 2026?

Countable resources must be at or below $2,000 for a single long-term-care applicant and $3,000 when both spouses are applying. These SSI-aligned figures appear on ODM's 2026 Medicaid Standards Help Sheet, and the limit is tested on the eligibility date.

Can I keep my home if I go into a nursing facility?

Yes. The home is exempt up to Ohio's 2026 home-equity cap of $752,000, and the cap is waived when a spouse or a minor or disabled child lives there, or when you sign an intent-to-return statement. Estate recovery may reach the home after death, but during life it is exempt.

Can I give money to my children to spend down?

No. Any gift or below-market transfer in the 60-month look-back is presumed improper and creates a penalty period. The IRS annual gift-tax exclusion does not apply to Medicaid, so even small gifts are counted.

How is the penalty for a gift calculated?

Ohio divides the transferred value by its Average Monthly Private Pay Rate of $7,787 a month (effective September 2024) to set the number of months Medicaid will not pay for care. A partial first month is prorated using the daily rate.

How much can I spend on a prepaid funeral?

There is no dollar limit when the contract is irrevocable, is with a licensed funeral home, and holds the funds with the funeral home or in an irrevocable trust. A revocable contract counts at its cash value.

Can I pay my child for caregiving without a penalty?

Only under a written personal services contract executed before services begin, at a reasonable documented rate with proper tax treatment. Without that contract, payments to family are presumed gifts and trigger the look-back penalty.

Learn More

MedicaidOhio Medicaid Eligibility & Income LimitsOhio Medicaid 2026 income and asset limits across the MAGI, ABD, and long-term-care pathways: the $2,982 income cap, the $2,000 asset limit, and Miller Trusts. MedicaidOhio Medicaid Transfer Penalty & Look-BackOhio Medicaid 60-month lookback in 2026: the $7,787 APPR penalty divisor, exempt transfers, the caregiver-child exception, and the DRA-2005 start-date rule. MedicaidOhio Medicaid Spousal ImpoverishmentOhio spousal impoverishment in 2026: CSRA $32,532-$162,660, MMMNA $2,705.00-$4,066.50, CSMIA income diversion, snapshot date, and HCBS waiver coverage. MedicaidOhio Miller Trust (Qualified Income Trust)How the Ohio Miller Trust works in 2026: when the $2,982 Special Income Limit triggers a QIT, trust setup, monthly deposits and distributions, and Form 10193. MedicaidOhio Medicaid Estate RecoveryHow Ohio's expanded Medicaid estate recovery reaches your home, what's exempt, the MAPT and caregiver-child planning that works, and where HB 318 stands. MedicaidHow to Apply for Ohio MedicaidHow to apply for Ohio Medicaid: the application channels, form ODM 07216, the 60-month look-back, processing timelines, retroactive coverage, and how to appeal.

Find personalized help planning your Ohio Medicaid spend-down at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.