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 much 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.,,

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 nursing-facility care and Ohio's home and community-based waivers, including the PASSPORT waiver, the Assisted Living Waiver, and the Ohio Home Care Waiver.,,, Next Generation MyCare does not get around it either: it is Ohio's integrated managed-care program for people who already have both full Medicaid and Medicare, and it succeeded the MyCare Ohio demonstration starting January 1, 2026 and had rolled out across the rest of Ohio by August 1, 2026. The figure that matters is countable resources, not a family's net worth. Hearing "$2,000" can sound like a family must end up with $2,000 to its name; the rule is narrower, because the home, one car used for transportation, and household goods and personal effects are exempt and never count.,

What "Countable" Means

Countable resources are what is left once the exclusions in the next section are taken out. Your county Department of Job and Family Services (CDJFS) applies Ohio's rules to your application, and Ohio's transfer rules also look back 60 months from the applicant's baseline date, so money that moved anywhere in that window can be reviewed.

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?

The exclusions below come from the federal Supplemental Security Income (SSI) resource rules, which most states use to decide Medicaid resource eligibility; Ohio's own figures are noted where Ohio publishes them.

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, and those are the only residents the statute names for it. 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

Under the federal SSI rules, one vehicle of any value is not counted if you or a member of your household use it for transportation, and household goods and personal effects are not counted either. Ask your CDJFS how Ohio will treat a second vehicle or a collection held as an investment before you count on keeping it.

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 is left out of the life-insurance face-value test below, which makes it easy to miss here, but it still reduces the burial fund dollar for dollar: a $1,200 burial insurance policy 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.

A prepaid funeral contract is a separate question. An irrevocable burial arrangement reduces the burial-fund exclusion, as above, but we cannot cite an Ohio rule on how the contract itself counts, so get your CDJFS's answer before you sign.

Life Insurance

Life insurance counts at its 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

No rule we can cite settles how Ohio treats an IRA, 401(k), or pension. 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 (only taxes owed because of the death and reasonable trust-administration fees may be paid first), 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.,
  • Set aside a burial fund. A separate, clearly designated burial fund is excluded up to $1,500, less the reducers above.
  • 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.
  • Pay family for care only at fair value. Ohio presumes a transfer for less than fair market value improper, so a payment to a relative has to buy care worth what was paid. Have an elder-law attorney put the arrangement in a written contract before the care starts, so the county can see what the money bought.

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 uncompensated value transferred divided by the average monthly cost of private-pay nursing-facility care, the formula federal law sets and Ohio's rule implements. For penalty months taking effect from September 2026, Ohio's divisor is $8,669 a month, up from $7,787. A leftover fraction of a month is not dropped: under OAC 5160:1-6-06.5 it becomes a partial month of restricted coverage, added to the first month's patient liability (or paid to the provider if there is none). Under federal law, the penalty begins on the later of the transfer date or the date the applicant is otherwise eligible and receiving institutional-level care. Federal law lets the state excuse it when denying eligibility would work an undue hardship, meaning it would endanger the applicant's health or life or leave them without food, clothing, shelter, or other necessities; Ohio takes those requests under OAC 5160:1-6-06.6.

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; a gift inside the look-back is presumed improper unless it fits one of the exceptions below.
  • 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 more for care than the care is worth.
  • Purchasing a non-compliant annuity, or funding an irrevocable trust for anyone the exceptions below do not protect.
  • Donating to charity, which buys the applicant nothing in return.

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, to a blind or disabled child or a trust for that child's sole benefit, or to a trust for the sole benefit of any disabled person under 65; and income moved into a qualified income trust. A sole-benefit arrangement must provide for spending on an actuarially sound basis, or the exception is void. The presumption can also be rebutted. Returning all of the transferred assets removes the penalty (a partial return does not), and a transfer made under a court order to support a spouse or family member carries no penalty.

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. The second position is conditional: if that spouse, or a representative of that child, disposes of any of the remainder for less than fair market value, the state must move to first. That second option still 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 for the asset test. The text does not settle whether a retirement annuity escapes the naming requirement, so do not assume it does, and states can add conditions to this federal floor.

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

Two different things go by the name spend-down, 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, Ohio's rules offer an optional Miller Trust, not an income spend-down.,

Feature Asset spend-down (this guide) ABD pay-in spend-down (ended August 1, 2016)
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 income standard
Look-back applies Yes, the federal 60-month look-back Not applicable; the route ended in 2016
Timing One-time, at application Monthly
Income rule Income managed separately through a Miller Trust if over the SIL Ended August 1, 2016; no monthly spend-down route today

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

The county totals the couple's countable resources to work out the spousal share the protected amount is measured against.

2
Step 2

Community Spouse Resource Allowance (CSRA)

The community spouse keeps a protected share of the snapshot total. Ohio uses the 2026 federal resource standards of $32,532 minimum and $162,660 maximum, but those do not cap the allowance itself: a fair hearing or a court order can set a higher one.,

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

The community spouse's own income is not counted against the institutionalized spouse in care. If it falls below the maintenance needs standard ($2,705.00 minimum from July 1, 2026; $4,066.50 maximum for 2026), the community spouse can receive the difference from the institutionalized spouse's income, and a fair hearing can raise it for exceptional circumstances.,

Before a couple spends anything, read the spousal impoverishment guide for how the snapshot is timed before you spend.

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. For the 55-or-older track, that means benefits paid after 55, excluding Medicare Savings Program help. Federal law has required only the probate estate since 1993; reaching beyond it is Ohio's choice.

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 interact with this expanded recovery, so the planning horizon runs past the eligibility date. Recovery waits until after a surviving spouse has died and while no surviving child is under 21, blind, or permanently and totally disabled; that delays recovery rather than cancelling it. 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, 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.

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 does not apply at all while your spouse, a child under 21, or a blind or disabled child lives there. Estate recovery may reach the home after death.,,

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 unless it fits one of Ohio's listed exceptions. 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 uncompensated value by the average monthly private-pay cost of nursing-facility care to get the months Medicaid will not pay for long-term care. For new penalties from September 2026 the divisor is $8,669, and a leftover fraction is added to first-month patient liability, not dropped.

How much can I spend on a prepaid funeral?

We cannot point you to an Ohio rule on how a prepaid funeral contract is counted, so ask your CDJFS before you sign. Under the federal SSI rules, an irrevocable burial arrangement reduces the separate $1,500 burial-fund exclusion dollar for dollar.

Can I pay my child for caregiving without a penalty?

Only if the payments buy care worth what you paid. Ohio presumes a transfer for less than fair market value improper and imposes a penalty period, so have an elder-law attorney put the arrangement in a written contract before the care starts.

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: how the APPR penalty divisor works, exempt transfers, the caregiver-child exception, and when the penalty starts. MedicaidOhio Medicaid Spousal ImpoverishmentOhio spousal impoverishment in 2026: CSRA standards of $32,532 and $162,660, the $2,705.00 MMMNA, CSMIA, the snapshot date, and when a hearing can go higher. 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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