If your parent needs assisted living in Ohio and qualifies for Medicaid, the Ohio Assisted Living Waiver pays for the care but not the rent. It covers the assisted-living service package inside a Medicaid-participating, licensed residential care facility (RCF) for adults who meet a nursing facility level of care, and caps what the resident pays for room and board at $944 a month in 2026,. It is a federal section 1915(c) Home and Community-Based Services (HCBS) waiver under Ohio Administrative Code Chapter 5160-33, and the Ohio Department of Medicaid and the Ohio Department of Aging together administer and operate Ohio's HCBS waivers for older adults. Its defining feature is that it never pays for housing.

Below: who qualifies, what the resident pays each month, how the waiver compares with the PASSPORT waiver and nursing-facility Medicaid, how to find a participating facility, and how to appeal. For the wider map, see the Ohio HCBS waivers overview, the Ohio assisted living guide, and how to apply.

What the Ohio Assisted Living Waiver Covers and What It Doesn't

The waiver is a funding mechanism, not a kind of building. Waiver residents live in the same licensed residential care facilities (RCFs) as private-pay residents. In Ohio, assisted living is regulated as a residential care facility licensed under Chapter 3721 of the Revised Code, and the Ohio Department of Health has jurisdiction over RCFs and investigates complaints against them, unannounced. All the waiver changes is who pays for the care.

What the Assisted Living Waiver pays for is the cost of care in the facility, paid to the participating RCF as the assisted-living service package,. Ask each facility exactly which services its Medicaid package includes before move-in.

What it does not pay for:

In a nursing facility, by contrast, Medicaid pays for the nursing facility care itself and the resident keeps a $75 personal needs allowance,.

Who Qualifies for the Assisted Living Waiver

Eligibility has four parts: an age floor, a clinical test, a setting requirement, and the financial limits. An applicant must be age 21 or older, which is why someone younger who needs waiver services at home uses the Ohio Home Care Waiver instead.

Nursing Facility Level of Care

Every Ohio HCBS nursing facility waiver requires a nursing facility level of care, and the Ohio Department of Aging describes the Assisted Living Waiver applicant as someone who needs hands-on help with dressing, bathing, toileting, grooming, eating or mobility.

Setting: A Medicaid-Participating RCF

The applicant must live in, or be moving to, a licensed RCF that participates in Medicaid, because that is the only kind of facility the waiver pays.

Financial Eligibility

PASSPORT and nursing-facility Medicaid use the same income route and asset limits:

  • Income at or below the Special Income Level, set at 300% of the $994 SSI federal benefit rate, or $2,982 a month for a single applicant in 2026,. Ohio opens it only to someone in a continuous period of institutionalization, including 30 consecutive days found eligible for and needing waiver services.
  • An applicant whose income exceeds $2,982 may bring countable income back under the line with a Qualified Income Trust (Miller Trust). Ohio's rule makes the trust an option, not a requirement, and only the applicant's own income can go into it,.
  • Countable assets at or below $2,000 for a single applicant, or $3,000 if both spouses apply.
  • For married couples with one spouse applying, ODM's 2026 resource standards for the spouse at home ($32,532 minimum, $162,660 maximum) are not caps: a court order, or a fair hearing applying the "income first" rule, can set more. The income standards ($2,705.00 from July 1, 2026, capped at $4,066.50) don't limit that spouse's own income; they size an allowance from the applicant's income that a court support order, or a hearing showing exceptional circumstances causing significant financial duress, can raise,.
  • No penalized asset transfers in the 60-month look-back, which runs backward from the application. Giving assets away for less than fair market value triggers a penalty period during which Medicaid will not pay for waiver services, unless an exception applies, such as a transfer to a spouse. See the transfer-penalty lookback guide.
  • Home equity at or below the $752,000 federal limit Ohio applies for 2026, though the equity test does not apply at all, at any equity value, where a spouse, a child under 21, or a blind or permanently and totally disabled child lawfully lives in the home,. Whether the home stays exempt as a resource after a permanent move to the RCF is a separate question; settle it with the county agency or an elder law attorney before the move.

See Ohio Medicaid eligibility and income limits and how to apply for Ohio Medicaid.

What the Resident Actually Pays Each Month

The resident has two separate income obligations, and both are limited by rule.

Room and board, paid to the facility, is capped. Under OAC 5160-33-03 an applicant must be able to make room and board payments calculated at the SSI federal benefit rate minus fifty dollars, and a facility may not charge more. Because the 2026 rate is $994, the most an Ohio RCF may charge a waiver resident in 2026 is $944, leaving a $50 personal cushion.

The cost-of-care contribution, called patient liability, is set separately. Under OAC 5160:1-6-07.1 the resident keeps a maintenance needs allowance equal to the full $994 rate, then pays income above that line toward waiver services, after deductions for a community spouse allowance, health-insurance costs including Medicare premiums and copayments, medical care Ohio recognizes but Medicaid does not cover, and a fee to administer a qualified income trust.

Put together: a resident keeps up to $994, covering the $944 room-and-board charge plus the $50 cushion, and income above that, net of the deductions, is patient liability. That figure is appealable. The rule requires written notice of the patient liability amount, and the notice must explain how to request a hearing if you disagree with it.

Income below the cap is not automatically forgiven. Enrollment requires the ability to make that room-and-board payment, so a resident whose income falls short of $944 does not simply pay less. OAC 5160-33-03 gives two ways to close the gap, neither automatic: informal supports, such as a family member, may pay up to the difference between the resident's income and the $944 maximum, and that supplement is not counted in patient liability; or the facility may elect a reduced rate. Settle which applies with the RCF before move-in.

Ohio sets the assisted-living personal cushion at $50 a month and the nursing-facility personal needs allowance at $75,. The assisted-living figure is the lower of the two. One more protection: a single veteran, or a veteran's surviving spouse, with no dependent minor or disabled child and receiving HCBS waiver services has up to $90 a month of VA pension, including aid and attendance, taken out of gross income before the patient-liability math starts. (The $30 federal personal-needs floor in 42 CFR 435.725 is not the waiver rule. For HCBS, federal rules let the state set the maintenance amount, and Ohio sets this waiver's at the full $994 SSI rate.)

Ohio Assisted Living Waiver vs. PASSPORT vs. Nursing-Facility Medicaid

All three pathways use the same $2,982 Special Income Level and $2,000 single-applicant limit on countable assets in 2026,,.

Feature Assisted Living Waiver PASSPORT Waiver Nursing-Facility Medicaid
Setting Licensed residential care facility (assisted living) The participant's own home or community Nursing facility (institutional)
Who it serves Adults age 21 or older meeting a nursing facility level of care Adults age 60 or older meeting an intermediate or skilled level of care People meeting a nursing facility level of care
Room and board Paid by resident, capped at $944/month in 2026 None; participant lives at home Part of the nursing facility care Medicaid pays for
Kept before patient liability $994/month allowance, which covers the $944 room and board and leaves about $50 $1,939/month allowance in 2026 $75/month personal needs allowance
What Medicaid pays Service payment to the RCF In-home and community services, within a $14,700/month cost limit (ODA can approve more once enrolled) Nursing facility care
Income cap (2026) $2,982/month Special Income Level $2,982/month Special Income Level $2,982/month Special Income Level

The allowance row comes from Ohio's patient-liability rules: $994 under the Assisted Living Waiver, $1,939 under PASSPORT and Ohio's other HCBS waivers, and $75 in a nursing facility. PASSPORT's $14,700 cost limit can be exceeded after enrollment with ODA approval.

What Assisted Living Costs Without the Waiver

Private-pay assisted living in Ohio runs a median of about $6,102 a month, roughly $73,230 a year, in the 2025 CareScout (formerly Genworth) Cost of Care Survey, and because that is a statewide median, prices in a given Ohio market can run well above or below it.

Finding a Medicaid-Participating Residential Care Facility

Because the waiver pays only a participating licensed RCF, the first task is finding one with an open Medicaid bed. The reliable approaches:

  1. Call the Area Agency on Aging at 1-866-243-5678 to reach the agency serving your community, and ask which RCFs in your area participate.
  2. Call facilities directly and ask two questions: "Do you participate in the Assisted Living Waiver?" and "Do you have a Medicaid bed open now, and what is the waitlist?"
  3. Work with a geriatric care manager who knows which local facilities participate.

When Memory Care Is Part of the Picture

Some assisted living residents need dementia care. Whether a participating RCF offers it, and whether the waiver payment there covers it, is a question for the facility and the Area Agency on Aging before the move. See assisted living vs. memory care in Ohio, or call the Alzheimer's Association's free 24/7 Helpline at 1-800-272-3900.

Moving Between PASSPORT, the Assisted Living Waiver, and a Nursing Facility

From PASSPORT to the Assisted Living Waiver. A PASSPORT participant, who must be 60 or older and whose needs must be safely met at home, can no longer be supported there. PASSPORT does not allow enrollment in another Medicaid home and community-based program at the same time, so the move means finding a participating RCF with a bed and switching waivers. The money changes too: on PASSPORT the participant keeps a $1,939 monthly allowance before patient liability, while an Assisted Living Waiver resident keeps $994, out of which the capped room and board is paid.

From the Assisted Living Waiver to a nursing facility. When clinical needs outgrow what an RCF can safely provide, the same income route and asset limit apply but the income math changes. In the RCF the resident keeps up to $994 and pays capped room and board from it; in a nursing facility Medicaid pays for the facility care, the resident keeps $75, and remaining income, after the allowed deductions, goes to patient liability,. Patient liability rises; the room-and-board bill disappears. See the Ohio nursing homes guide.

Each move also changes estate-recovery exposure. Ohio elects expanded Medicaid estate recovery, reaching both probate and many non-probate assets, for a permanently institutionalized recipient of any age and for anyone 55 or older. Two limits ride with that breadth: for the 55-or-older track, recovery reaches only benefits paid after that birthday, and Medicare Savings Program benefits paid since January 1, 2010 are excluded entirely. See the Ohio estate recovery guide.

How the Waiver Works in MyCare Ohio Counties

Ohio has moved people 21 and older who have both full Medicaid and Medicare, and who meet its other criteria, into Next Generation MyCare, an integrated managed-care program built as a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP). ODM launched it in 29 counties on January 1, 2026 and expanded statewide between April 1 and August 1, 2026. Three plans are open to new members statewide: Anthem Blue Cross and Blue Shield, CareSource, and Molina Healthcare of Ohio. Buckeye Health Plan is not an option for new members in plan year 2026, though current Buckeye members need do nothing to stay. A MyCare member living in assisted living receives services under the MyCare waiver and keeps the same $994 maintenance allowance as an Assisted Living Waiver resident, and an appeal goes to the plan first (see below). See the MyCare Ohio guide.

Adults under 60 who need a waiver in the community rather than an RCF generally use the Ohio Home Care Waiver, which serves Ohioans from birth through 59 and disenrolls them within 120 days of their 60th birthday, with an offer to move to PASSPORT.

Appealing a Denial or a Service Cut

A denial, a refused service request, or a reduction all carry state-hearing appeal rights through the Ohio Department of Job and Family Services Bureau of State Hearings.

  • Filing window: ODJFS must receive the state hearing request within 90 days of the mailing date of the notice of action. Federal rules set 90 days as the outside limit a state may allow.
  • Aid pending runs on a much shorter clock: 15 days, not 90. To keep services already in place running at the prior level during the appeal, the hearing request must go in within 15 days of receiving the notice. Missing it does not cost you the appeal, and it may not cost you the services either: if the agency receives the request within 10 calendar days after the action takes effect and you show good cause, such as a death or sudden illness in the family, benefits are reinstated retroactively to the date they were cut. Where the action came with no prior notice, a request within 15 days of the mailing date does the same. If continued assistance is paid and you then lose, you may have to repay benefits you were not eligible to receive.
  • On a MyCare or other managed-care plan, appeal to the plan first. A managed-care member must generally exhaust the plan's internal appeal before requesting a state hearing: file with the plan orally or in writing within 60 calendar days of the date the plan's notice of action was issued, then, after an adverse plan decision, request the state hearing within 90 calendar days of that resolution. If the plan misses its own notice and timing requirements, you are deemed to have exhausted its appeal and can go straight to the state hearing.
  • How to file: call or write your county Department of Job and Family Services, write to ODJFS Bureau of State Hearings, PO Box 182825, Columbus, Ohio 43218-2825, or mail or fax (614-728-9574) the request form that came with the notice. A request someone else makes must be in writing, with the individual's signed statement naming them as representative.
  • The Bureau of State Hearings line, 1-866-635-3748, is for two narrower things: asking to take part in the hearing by phone, and asking whether you should be receiving continuing benefits.

You can also call the Ohio Long-Term Care Ombudsman hotline at 1-800-282-1206 or reach your regional ombudsman program.

Mistakes Families Make

  1. Assuming every licensed RCF participates. The waiver pays only a Medicaid-participating facility. Confirm participation and an open bed before you commit.
  2. Misreading room and board. It is capped at $944 a month in 2026, not "all of your income".
  3. Treating the home as automatically safe. A permanent move raises questions about the home's exempt status, and Ohio's expanded estate recovery can later reach assets that pass outside probate.
  4. Missing the spousal income allowance. For couples, a monthly income allowance for the spouse at home comes out before patient liability is set,.
  5. Not coordinating Medicaid timing with the RCF. Line up the enrollment date with the facility to avoid a billing dispute.
  6. Missing the 15-day aid-pending window. The 90-day filing deadline is generous, but keeping services running during the appeal takes a request within 15 days.

Frequently Asked Questions

How much does an Ohio Assisted Living Waiver resident pay each month?

Room and board is capped at $944 a month in 2026 (the $994 SSI federal benefit rate minus $50), leaving about $50 for personal needs. Income above the $994 maintenance allowance, after the allowed deductions, is patient liability toward services, so a resident at or below $994 owes no cost-of-care contribution. If income is below $944 that gap is not automatically forgiven: under OAC 5160-33-03 a family member may pay the difference, or the facility may elect a reduced rate. Settle it with the RCF before move-in.

What is the difference between the Assisted Living Waiver and PASSPORT?

Both require a nursing facility level of care and share the $2,982 Special Income Level in 2026. PASSPORT serves adults 60 or older at home, with a $1,939 monthly allowance; the Assisted Living Waiver serves adults 21 or older in a licensed RCF, where the resident keeps $994 and pays capped room and board from it. You can't be on both at once.,,

Do I have to live in the RCF before applying?

Plan the timing rather than guess at it. Ask the Area Agency on Aging and the facility's admissions team how to line up the financial application, the level-of-care assessment and the move-in date, so no month falls between private pay and Medicaid.

How do I find a Medicaid-participating RCF in Ohio?

Call the Area Agency on Aging at 1-866-243-5678 to reach the agency serving your community and ask which local RCFs participate, then call facilities directly to confirm participation and an open Medicaid bed.

Does the Assisted Living Waiver cover memory care?

It depends on the facility. Ask the RCF and the Area Agency on Aging whether it offers dementia care and whether the waiver payment covers it.

What happens if my parent's needs exceed what the RCF can provide?

If the RCF can no longer serve the resident safely, the usual next step is nursing-facility Medicaid. The same income route and asset limit apply, but the resident keeps the $75 personal needs allowance instead of the $994 maintenance allowance: patient liability rises, and the room-and-board charge ends.,,

Can my parent keep their home while on the waiver?

For eligibility, home equity above Ohio's $752,000 limit for 2026 bars long-term care Medicaid, unless a spouse, a child under 21, or a blind or disabled child lives there,. After death, Ohio's expanded estate recovery can reach the home, though recovery waits until any surviving spouse has died and cannot proceed while a child under 21 or a blind or disabled child survives. Ask an Ohio elder law attorney before the move.

Can I appeal a denial of waiver coverage?

Yes, and watch two deadlines: 90 days from the notice's mailing date to request the state hearing, and 15 days to keep services already in place running while the appeal is pending. On a MyCare or other managed-care plan, appeal to the plan first, within 60 days of its notice, then request the state hearing within 90 days of the plan's decision. File by calling or writing your county Department of Job and Family Services, or by mailing or faxing the request form that came with the notice to the ODJFS Bureau of State Hearings.

Next Steps for Ohio Families

1
Step 1

Confirm the clinical fit

Assisted living suits residents needing more than home care can safely provide but less than skilled nursing. Talk with the physician or the Area Agency on Aging.

2
Step 2

Call the Area Agency on Aging at 1-866-243-5678

It connects you to the agency serving your community. Ask how to start the level-of-care assessment and the financial application, and which local RCFs participate.

3
Step 3

Tour participating RCFs

Confirm bed availability, whether the facility offers dementia care if needed, the room-and-board charge, and what the service payment covers.

4
Step 4

Run the room-and-board math

Start from the $944 cap and the $994 maintenance allowance, then account for Medicare premiums and any community spouse income allowance.

5
Step 5

Address the home early

For a permanent move, see an Ohio elder law attorney about exemption, transfers, and estate recovery first.

Where to Get Help

Area Agency on Aging Connects you to the agency serving your community. 1-866-243-5678https://dam.assets.ohio.gov/aging.ohio.gov/AAA-map.pdf
Ohio Medicaid Consumer Hotline Staff can help you complete a Medicaid application. 1-800-324-8680https://www.ecfr.gov/current/title-42/section-435.907
Ohio Department of Aging Waiver program information and referrals. aging.ohio.gov
Ohio Long-Term Care Ombudsman State hotline; regional ombudsman programs also serve each area. 1-800-282-1206https://dam.assets.ohio.gov/image/upload/aging.ohio.gov/Regional_Ombudsman_Contact_Map.pdf
Bureau of State Hearings (appeals) To take part in a hearing by phone, or to ask about continuing benefits. 1-866-635-3748https://www.ecfr.gov/current/title-42/section-431.221
Ohio Department of Health Complaints about licensed facilities; ODH prefers its online complaint form. 1-800-342-0553https://odh.ohio.gov/know-our-programs/home-health-agencies/enforcement-complaints
Alzheimer's Association 24/7 Helpline Free, confidential dementia support, around the clock. 1-800-272-3900https://www.kdads.ks.gov/services-programs/aging/alzheimer-s-disease-and-dementia alz.org

Learn More

MedicaidOhio HCBS WaiversEvery Ohio Medicaid HCBS waiver: PASSPORT, the Assisted Living Waiver, the Ohio Home Care Waiver, MyCare Ohio, and the DODD waivers (IO, Level One, SELF). MedicaidOhio PASSPORT WaiverHow the Ohio PASSPORT waiver works in 2026: age 60+ NF level-of-care eligibility, the assessment, AAA case management, services, and the $14,700 cost cap. 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 Personal Needs AllowanceOhio Medicaid raised the nursing facility Personal Needs Allowance to $75/month effective 1/1/2026. Assisted Living Waiver room-and-board cushion stays at $50. 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 navigating the Ohio Assisted Living Waiver 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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