Ohio Medicaid Income Limits 2026: $1,835 MAGI & $2,982 LTC Cap

Most Ohio families dealing with Medicaid need only two or three numbers: the income limit that applies to their situation, the $2,000 asset limit, and whether being over the limit bars them. For long-term care, Ohio is an income-cap state, so income above $2,982 a month in 2026 does not disqualify an applicant outright, but it does force the income through a Miller Trust first. This guide gives you the operative figure for each pathway and tells you exactly what to do if you are over it.

In This Guide

• Three Structural Facts That Shape Every Case
• The Three Pathways for Adult Applicants
• Ohio Medicaid Income Limits for 2026
• Who Qualifies Under MAGI
• Who Qualifies Under the ABD Pathway
• Ohio Long-Term-Care Medicaid Income Limits in 2026
• Miller Trusts: When and How
• Spousal Impoverishment Protections
• Spending Down Excess Assets
• The Transfer Penalty and 60-Month Lookback
• Medicare Savings Programs for Dual Eligibles
• How to Apply for Ohio Medicaid
• What Changes in 2027 and 2028
• Frequently Asked Questions
• Learn More

Three Structural Facts That Shape Every Case

Three things about how Ohio Medicaid is structured decide which numbers apply to a given family. Get these wrong and the rest of the analysis falls apart.

Ohio Treats SSI Recipients as Automatically Eligible

Ohio is a Section 1634 state, meaning the state accepts the Social Security Administration's Supplemental Security Income (SSI) decision as its Medicaid decision. If your loved one receives SSI in Ohio, they already have coverage; no separate application is required. Authority: OAC 5160:1-3-02.3.

Ohio was historically a 209(b) state but converted to 1634 status on August 1, 2016, so older guidance that calls Ohio a 209(b) state is out of date. To confirm a card or managed-care assignment, call the Ohio Medicaid Consumer Hotline at 1-800-324-8680.1,4

Ohio Caps Income for Long-Term Care

For nursing-facility and home-and-community-based-services (HCBS) waiver Medicaid, Ohio sets a hard income ceiling, the Special Income Level, at 300% of the SSI federal benefit rate. The 2026 figure is $2,982 a month for a single applicant. An applicant whose gross monthly income exceeds $2,982 cannot get long-term-care Medicaid in Ohio without routing income through a Qualified Income Trust, also called a Miller Trust. Authority: OAC 5160:1-6-03.1.1,5

Ohio Ended Its ABD Spend-Down in 2016

This is the most frequently confused fact in Ohio Medicaid, and most consumer guides still have it wrong. Ohio did run an aged, blind, or disabled (ABD) spend-down, but it ended when the state became a Section 1634 state. The Ohio Department of Medicaid says so directly: "When Ohio becomes a 1634 state on August 1, 2016, individuals will no longer be able to spenddown to become eligible for Medicaid." Ohio also does not extend medically-needy coverage to long-term care, so there is no medically-needy route around the income cap either. The rule that used to carry the ABD spend-down, OAC 5160:1-3-04.1, no longer exists.1

Previously circulated "$691/$727" medically-needy income figures for Ohio are incorrect and should not be used.1

The Three Pathways for Adult Applicants

Adult Ohioans seeking Medicaid fall into one of three primary tracks. The pathway determines every figure that applies, so identify it first.

• MAGI (Modified Adjusted Gross Income): non-disabled adults under 65, primarily Group VIII expansion adults at 138% of the Federal Poverty Level. Income test only, no asset test. Authority: OAC 5160:1-4.2
• ABD (aged 65+, blind, or disabled, non-long-term-care): for aged/blind/disabled adults not in a nursing facility and not on an HCBS waiver. Income at or below the SSI federal benefit rate (plus a $20 disregard). There is no spend-down above that limit; Ohio ended the ABD spend-down on August 1, 2016. Asset limit $2,000 single, $3,000 couple. Authority: OAC 5160:1-3.1
• Long-term care (institutional or HCBS waiver): for nursing-facility, PASSPORT, Assisted Living, Ohio Home Care Waiver, or MyCare Ohio Waiver coverage. Income at or below the $2,982 Special Income Limit, or above it with a Miller Trust; assets at or below $2,000. Subject to the 60-month lookback. Authority: OAC 5160:1-6.1,6

A quick routing test: nursing-facility care is the long-term-care pathway. PASSPORT in-home care for ages 60+ is the long-term-care pathway. An adult under 65 with no long-term-care need is MAGI. An aged person living at home who needs only primary care and prescriptions is ABD.

Ohio Medicaid Income Limits for 2026

All figures below are monthly unless noted, and reflect the 2026 program year (the SSI federal benefit rate rose 2.8% with the January 2026 cost-of-living adjustment).7

The SSI federal benefit rate, the $2,982 Special Income Limit, and the $994/$1,491 ABD standard are set by federal cost-of-living indexing and Ohio rule.7,1 Note that the Special Income Limit is stated for an individual and is tested against each applicant's own income, so there is no combined couple ceiling: when one spouse enters care and the other stays home, it is that spouse's own gross income measured against $2,982, and the spousal-impoverishment rules below govern the rest.1 The Group VIII figures are 138% of the 2026 Federal Poverty Level ($15,960 a year for one person, $21,640 for two).2

The $2,000 single / $3,000 couple asset limit applies to the ABD and long-term-care pathways; MAGI groups have no asset test.1

The CSRA range ($32,532 to $162,660) and the MMMNA figures ($2,705.00 floor through June 30, 2027; $4,066.50 maximum) are the federal spousal-impoverishment standards Ohio applies.3 The nursing-facility Personal Needs Allowance is $75 a month (raised from $50 by an amendment to OAC 5160:1-6-07 effective January 1, 2026), up to $140 with the earned-income deduction.8 Ohio applies the federal home equity minimum of $752,000.5 The transfer penalty divisor is $7,787, set effective September 1, 2024 and carried unchanged into the 2026 Ohio Medicaid Standards Help Sheet.1

Who Qualifies Under MAGI

MAGI Medicaid covers non-disabled adults under 65, parents and caretaker relatives, pregnant women, and children. It uses an income test only, with no asset test.

Group VIII (expansion adults 19 to 64). Covered up to 138% of the Federal Poverty Level, about $1,835 a month for one person in 2026. No dependent-children requirement. Group VIII enrollees receive the Alternative Benefit Plan, which mirrors the essential health benefits but excludes long-term-care services. An enrollee who later needs long-term care must move to the long-term-care pathway, which has an asset test and a lookback.2

Parents and caretaker relatives. A lower income threshold than Group VIII, so most parents qualify under Group VIII instead. This pathway exists for families in categories Group VIII does not reach. Authority: OAC 5160:1-4-03.

Pregnant women and children. Pregnant women qualify at a higher percentage of the Federal Poverty Level, with coverage continuing 12 months postpartum. Children qualify at thresholds that depend on whether they have other creditable insurance, with 12-month continuous eligibility. Authority: OAC 5160:1-4-02; OAC 5160:1-5-03.

Something to check if a disabled child is involved: TEFRA, also called the Katie Beckett option, is an optional state-plan eligibility group that lets a state cover a child 18 or younger who needs an institutional level of care while disregarding the parents' income and resources. Because it is a state option rather than a federal requirement, not every state has taken it up, so ask your county whether Ohio has one before assuming a child is over income.9 The other route is a 1915(c) waiver through the Ohio Department of Developmental Disabilities (Individual Options, Level One, or SELF) or the Ohio Home Care Waiver. These waivers carry waiting lists, so a family in this position should start asking early. Families with a disabled child whose income disqualifies them under SSI deeming should research these waivers immediately given the waitlists.

Who Qualifies Under the ABD Pathway

The aged/blind/disabled pathway covers Ohioans who are 65 or older, blind, or disabled under the Social Security Administration's criteria. There are three sub-tracks.

SSI categorical. If the individual receives SSI, Ohio Medicaid is automatic; no separate application. The 2026 SSI federal benefit rate is $994 a month for an individual, $1,491 for a couple, with a $2,000/$3,000 asset limit. Authority: OAC 5160:1-3-02.3.1

ABD categorically needy. For someone who does not receive SSI but meets the income and asset limits. The income standard is the SSI federal benefit rate plus a $20 standard disregard, roughly $1,014 a month. Authority: OAC 5160:1-3-02.4.1

No ABD spend-down. As covered above, Ohio ended it on August 1, 2016. An ABD applicant in the community whose income is above the limit cannot buy in by documenting medical expenses or by paying the county a premium-style "pay-in." For long-term care above the Special Income Level, the mechanism is a Miller Trust.1

One commonly missed protection: under the federal Pickle Amendment, a state must keep Medicaid in place for someone who is receiving Social Security, lost SSI after April 1977 solely because cost-of-living increases raised their income, and would still qualify for SSI if every increase since then were subtracted back out. It is a counterfactual test, so ask the county to run it rather than assuming.10

Ohio Long-Term-Care Medicaid Income Limits in 2026

Long-term-care Medicaid covers nursing-facility care, PACE (the Program of All-Inclusive Care for the Elderly), and the 1915(c) home-and-community-based waivers (the PASSPORT, Assisted Living, Ohio Home Care, and MyCare Ohio programs). The financial gate has two parts: income at or below the Special Income Limit (or above it with a Miller Trust), and countable assets at or below $2,000 for the institutionalized applicant.1

The 2026 Special Income Limit is $2,982 a month, equal to 300% of the $994 SSI federal benefit rate. It is computed from gross income, including Social Security retirement and disability benefits, pensions, IRA required-minimum-distributions, and net rental income. If gross monthly income is at or below $2,982, no Miller Trust is needed. If it exceeds $2,982, even by a few dollars, a Miller Trust is mandatory; there is no "close enough" threshold. Authority: OAC 5160:1-6-03.1.1,7

The asset limit for the institutionalized applicant is $2,000. The principal residence is excluded during the applicant's lifetime (subject to the home equity limit), as is one vehicle of any value, household goods, and irrevocable burial arrangements. Home equity above $752,000 disqualifies the applicant from long-term-care coverage unless a spouse, a child under 21, or a blind or disabled child of any age lawfully lives in the home.5,1

Once the applicant qualifies, the post-eligibility calculation lets the nursing-facility resident keep a $75 Personal Needs Allowance, with the rest of their income (after Medicare premiums and any spousal allowance) paid to the facility as patient liability.8 For the deeper mechanics, see the Ohio Personal Needs Allowance guide and the long-term-care nursing-home guide.

Miller Trusts: When and How

For a long-term-care applicant with gross monthly income above $2,982, a Qualified Income Trust (Miller Trust) is mandatory under Ohio rule, which implements the federal authorization at 42 U.S.C. 1396p(d)(4)(B). Without one, there is no long-term-care coverage; with one properly operated, income above the cap no longer disqualifies the applicant.5

Under OAC 5160:1-6-03.2, the trust must be irrevocable, may be funded only with the individual's own income (no other person's money and no other assets, except interest the trust earns), and must name the Ohio Department of Medicaid as remainder beneficiary up to the total Medicaid it paid. Each month the applicant deposits enough income into the trust to bring the income outside the trust to or below $2,982, then disburses it in an authorized order: a personal or maintenance needs allowance, a spousal or dependent allowance if applicable, health-care costs including patient liability, and up to fifteen dollars a month for bank fees and the attorney and administration costs of running the trust (the Ohio Department of Medicaid must approve anything higher). Deposits and disbursements must happen within the same calendar month. The trust document, proof the account exists, and Form ODM 10193 are filed with the application, and monthly deposits are reviewed at each annual recertification.5

For the full step-by-step, see the Ohio Miller Trust guide.

Spousal Impoverishment Protections

When one spouse enters long-term care and the other stays in the community, federal spousal-impoverishment rules protect the at-home (community) spouse. Ohio applies the federal standards.

At the resource snapshot, taken on the first day of the first 30 days of continuous institutionalization, the couple's countable resources are tallied. The community spouse keeps half, subject to a floor of $32,532 and a ceiling of $162,660 (the CSRA). The institutionalized spouse must spend down to $2,000. On the income side, if the community spouse's own income falls below the Minimum Monthly Maintenance Needs Allowance ($2,705.00 floor through June 30, 2027, up to a $4,066.50 maximum), income shifts from the institutionalized spouse to bring the community spouse up to that allowance.3,1

Because the resource snapshot and the CSRA election drive a great deal of planning, married couples should engage an Ohio elder-law attorney before the snapshot. See the Ohio spousal impoverishment guide for the full calculation.

Spending Down Excess Assets

For an applicant with countable assets above the $2,000 limit, the legal path to qualify is to convert countable assets into exempt ones or spend them on legitimate expenses, not to give them away.1

Allowable moves include paying outstanding medical bills, pre-paying an irrevocable burial contract, buying burial spaces, paying off a mortgage on the principal residence, making necessary home repairs, replacing a vehicle, and paying reasonable elder-law attorney fees. Disallowed moves, which trigger a transfer penalty, include gifting cash to relatives, adding a child to a deed without compensation, and buying assets in someone else's name. See the Ohio asset spend-down guide for the detailed menu.

The Transfer Penalty and 60-Month Lookback

Ohio reviews asset transfers made within 60 months (five years) before a long-term-care Medicaid application. Any uncompensated transfer in that window is presumed improper and generates a penalty period of long-term-care ineligibility. Authority: OAC 5160:1-6-06; the federal basis is 42 U.S.C. 1396p(c).11,5

The lookback applies only to long-term care (institutional and waiver); it is not applied to MAGI or community ABD coverage. The penalty period equals the total transferred amount divided by Ohio's average monthly private-pay rate of $7,787. A $100,000 uncompensated gift made within the lookback creates roughly 12.8 months of ineligibility, calculated from the later of the transfer date or the date the applicant would otherwise be eligible. There is no aggregate cap; multiple transfers within the window are summed. Authority: OAC 5160:1-6-06.5.1,11

One powerful exception: a home transferred to an adult child who lived in it for at least two years and provided care that postponed institutionalization is not a penalized transfer and is removed from estate-recovery exposure. See the Ohio transfer penalty and lookback guide for the full set of exceptions and the undue-hardship waiver. Ohio also runs an aggressive recovery against the estates of deceased recipients under ORC 5162.21, covered in the Ohio estate recovery guide.12,5

Medicare Savings Programs for Dual Eligibles

For Ohioans who have Medicare but limited income, four Medicare Savings Programs help pay Medicare costs. Three of them are sorted by income relative to the Federal Poverty Level and are shown below; the fourth, Qualified Disabled and Working Individual (QDWI), is a narrower program that pays the Part A premium for certain working people with disabilities who lost premium-free Part A (2026 limits: income $5,405 a month for an individual, resources $4,000).13

The 2026 single-person income limits are $1,350 (QMB), $1,616 (SLMB), and $1,816 (QI); the resource limit for those three is $9,950 for an individual and $14,910 for a couple. Those dollar figures are the stated percentage of the Federal Poverty Level plus the $20 monthly SSI general income exclusion, which is why $1,350 does not equal 100% of the $15,960 annual poverty guideline divided by twelve. They are the federal standard rather than an absolute cutoff: states can effectively raise both the income and the resource limits by disregarding amounts or certain types of income and resources, so an Ohioan somewhat over these figures may still qualify and should apply rather than rule themselves out. Two bounds matter before you count on one of these programs: QMB is what pays Medicare cost-sharing, and federal law bars providers from billing a QMB enrollee for Part A or Part B deductibles, coinsurance, or copays, while SLMB and QI pay the Part B premium and nothing else. QI is also awarded first-come, first-served out of a limited annual federal allocation, must be applied for again every year, and cannot be held at the same time as full Medicaid, so an Ohioan already receiving full Medicaid is looking at QMB or SLMB rather than QI. Enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help, the federal Part D low-income subsidy; QDWI does not carry Extra Help.13 See the dedicated Ohio Medicare Savings Programs guide and the dual-eligible MyCare Ohio guide.

How to Apply for Ohio Medicaid

Work through these steps to figure out which pathway you fall under and file the right forms.

If your situation is straightforward, a Group VIII adult, a child, a pregnant woman, or an SSI recipient, you can often apply yourself. If you are over 65, applying for nursing-home or waiver Medicaid, married with a community spouse, or holding assets above the limit, engage an Ohio elder-law attorney before you move money. For a full walkthrough, see the Ohio how-to-apply guide.

Where to Get Help

What Changes in 2027 and 2028

Federal law enacted in 2025 (Public Law 119-21, the One Big Beautiful Bill Act, signed July 4, 2025) changes several Ohio Medicaid figures on a delay:

• Group VIII work requirement, not in force yet. A federal community-engagement requirement applies to the expansion adult group no later than January 1, 2027.16 Nobody has to meet it before their state's start date: that date is January 1, 2027 unless Ohio elects to begin earlier, and a state demonstrating a good-faith implementation effort can be granted a federal exemption that expires no later than December 31, 2028. Once the requirement applies, an enrollee will satisfy it for a month with 80 hours of qualifying activity, or with monthly income at least equal to the federal minimum wage times 80 hours, which the implementing rule computes as $580 a month at the 2026 federal minimum wage of $7.25 an hour and measures on MAGI-based household income.15 Expansion enrollees should get ready to document qualifying activity or claim an exemption ahead of that date; nothing is required of them today.
• Retroactive coverage shrinks 1/1/2027. The current three-month retroactive window drops to one month for the Group VIII expansion group and two months for all other enrollees.15
• Group VIII redetermination drops to six months on 1/1/2027. Other pathways stay on the 12-month cycle. Its only exemption covers an Indian or Urban Indian as defined in the Indian Health Care Improvement Act, a California Indian, and anyone otherwise determined eligible as an Indian for the Indian Health Service. The same law separately excuses a longer list of people from its new community-engagement (work) requirement, including someone who is medically frail or the parent or caretaker relative of a dependent child 13 and under. A work-requirement exemption is not a renewal exemption: an expansion adult who is medically frail still renews every six months.15
• Home equity flat cap on 1/1/2028. Section 71108 of Public Law 119-21 replaces the indexed home equity band with a flat $1,000,000 cap (non-agricultural homes), which for Ohio is a relaxation from the current $752,000 figure.5

Because the income, asset, and spousal figures reset each January (and the MMMNA floor each July), revisit this guide at the start of each year for the current numbers.

Learn More

Find personalized help understanding your Ohio Medicaid eligibility 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.