Ohio Medicaid Guide: Eligibility, Waivers & Next Gen MyCare (2026)

Ohio Medicaid covers millions of Ohioans, from children and pregnant women to seniors in nursing homes and adults with disabilities. It runs through the Ohio Department of Medicaid (ODM), the joint federal-state health insurance program for people with limited income. For long-term care applicants, Ohio is an income-cap state: the 2026 Special Income Level is $2,982 per month (300% of the SSI Federal Benefit Rate), and anyone over that limit needs a Qualified Income Trust (Miller Trust) to qualify.1

For families navigating Ohio Medicaid in 2026, a major change is the transition from the MyCare Ohio Medicare-Medicaid Plan (MMP) demonstration to Next Generation MyCare, Ohio's Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) for people age 21 and older who have both Medicare and Medicaid. It launched January 1, 2026 in 29 counties and rolls out statewide through August 2026.2

If you're a family caregiver, an aging Ohioan, a person with a disability, or a guardian working through Ohio Medicaid for the first time, this guide is your starting point. We cover what Medicaid does in Ohio, how it works for elderly and disabled adults (including long-term services and supports through PASSPORT, Assisted Living, Ohio Home Care, the new MyCare Ohio Waiver, and the DODD waivers), how to apply, financial eligibility for 2026, the Next Gen MyCare transition, Ohio's unusually broad estate recovery (and the pending HB 318 reform), and where to turn for free counseling and legal help.

For a deep dive on the dual-eligible architecture, see our Next Generation MyCare Ohio guide. For the federal context on FIDE-SNPs, see our federal FIDE-SNP hub.

60-Second Version

Coverage: Ohio Medicaid is delivered through ODM. Mainstream Medicaid Managed Care for non-dual populations is delivered by 7 plans (AmeriHealth Caritas, Anthem, Buckeye, CareSource, Humana Healthy Horizons, Molina, UHC Community Plan). Dual-eligibles age 21+ in Next Gen-launched counties enroll in Next Generation MyCare (4 plans: Anthem, Buckeye, CareSource, Molina, with Buckeye closed to new enrollees in PY2026). OhioRISE (Aetna Better Health) covers complex BH youth.

Three Ohio Medicaid eligibility pathways for adults:

1. Modified Adjusted Gross Income (MAGI): ages 19-64, expansion population, parents/caretakers, pregnant women, income test only, no asset test.
2. Aged, Blind, Disabled (ABD): 65+ or disabled, income $994/month (single, equal to the SSI Federal Benefit Rate) and asset limit $2,000 (single).
3. Long-Term Care/HCBS Special Income Limit: $2,982/month single (300% of the SSI Federal Benefit Rate); above this requires a Qualified Income (Miller) Trust.1

1634 state: SSI receipt means automatic Medicaid (no separate application). Ohio became an income-cap (1634) state in 2014, converted from prior 209(b) status.1

1915(c) HCBS waivers: PASSPORT (age 60+), Assisted Living Waiver (21+), Ohio Home Care Waiver (18-59 physical disability), MyCare Ohio Waiver (capitated under Next Gen MyCare for duals), and the DODD Individual Options/Level One/SELF waivers (intellectual and developmental disabilities).6

Look-back: 60 months for institutional/HCBS only. No community Medicaid look-back in Ohio.1

Estate recovery: Ohio elects expanded recovery, reaching non-probate assets, transfer-on-death accounts, joint property, payable-on-death accounts, and living/revocable trusts under ORC 5162.21. HB 318 proposes narrowing recovery toward probate-only with low-value waivers, but was not enacted as of May 2026.4

How to apply: Online at benefits.ohio.gov, by paper Form JFS 7200 to your County Department of Job and Family Services (CDJFS), or by phone (800-324-8680). Long-term care applications go through the same CDJFS but require the Adult Comprehensive Assessment Tool (ACAT) administered by your local Area Agency on Aging.1,5

Costs for context: a semi-private nursing home room in Ohio runs about $110,230 per year (roughly $9,186 per month) for 365 days of care, per the CareScout 2025 Cost of Care Survey released March 2, 2026; Medicaid covers the full cost once you meet financial and clinical eligibility.7

The 2026 Story: MyCare MMP to Next Gen MyCare

The federal CY2023 Medicare Advantage and Part D Final Rule (87 FR 27704, May 9, 2022) terminated all Financial Alignment Initiative (FAI) Medicare-Medicaid Plan demonstrations effective December 31, 2025. Ohio's MyCare Ohio MMP, which operated from May 2014 through 12/31/2025 in 29 counties grouped into 7 AAA regions, was one of 11 states affected.

Ohio's response: Next Generation MyCare, a Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) under 42 CFR 422.2. Key changes from MMP:

• Four awarded carriers (instead of MMP's five): Anthem Blue Cross and Blue Shield Ohio (NEW entrant), Buckeye Health Plan (closed to new PY2026 enrollees), CareSource MyCare Ohio (continuing), Molina HealthCare of Ohio MyCare (continuing).
• Aetna Better Health of Ohio and UnitedHealthcare Community Plan EXITED Next Gen entirely. Aetna continues OhioRISE only; UHC continues mainstream Medicaid managed care only.
• Statewide expansion: 29 counties on 1/1/2026 to 88 counties by 8/1/2026 through six monthly tranches.
• Eligibility minimum age raised from 18 (MMP) to 21 (Next Gen).
• MyCare Ohio Waiver consolidates PASSPORT, Assisted Living, and Ohio Home Care waivers for dual-eligible MyCare members under OAC 5160-58.
• CO-D-SNPs (Coordination-Only D-SNPs) are no longer permitted for this population in Ohio, full integration is required.
• Exclusively Aligned Enrollment (EAE) under 42 CFR 422.514(h) is federally mandatory for FIDE-SNPs since 1/1/2025.2

The phased rollout schedule:2

• January 1, 2026, 29 counties (legacy MMP regions across 7 AAAs).
• April 1, 2026, 10 additional counties (parts of AAA4, AAA6, AAA11/Ashtabula).
• May 1, 2026, AAA2, AAA3, AAA5 county additions.
• June 1, 2026, AAA7 counties.
• July 1, 2026, AAA9 counties.
• August 1, 2026, AAA8 counties (statewide complete).

For full operational detail on the carriers, eligibility, MyCare Ohio Waiver, and pitfalls, see Next Generation MyCare Ohio.

Who Ohio Medicaid Covers

Ohio Medicaid covers these groups, at the 2026 income limits shown:1

• Children (Healthy Start CHIP-style): CHIP1 to 156% FPL (no premium) and CHIP2 from 156% to 206% FPL (premium tier).1
• Parents and caretaker relatives in households with children (under MAGI rules) up to 90% FPL.
• Adults age 19-64 (Medicaid Expansion under ORC Chapter 5163, Group VIII) up to 138% FPL.
• Pregnant women up to 200% FPL.
• Aged, Blind, Disabled (ABD) adults (65+, blind, or disabled per SSA standards), typically through SSI receipt or affirmative eligibility application.
• Persons receiving long-term services and supports (LTSS), including nursing facility residents, HCBS waiver participants, and Next Gen MyCare enrollees.
• Children with disabilities including those served by OhioRISE (BH-complex youth) and DODD waivers (I/DD).
• Working persons with disabilities through Medicaid Buy-In for Workers with Disabilities (MBIWD) under ORC § 5163.094.

CHIP for children above 138% FPL up to 206% FPL is delivered through the same Medicaid managed care infrastructure (Healthy Start Buckeye, etc.).1

The Three Ohio Medicaid Eligibility Pathways for Adults

For full operational detail on each pathway, 2026 income/resource thresholds, Group VIII / parents / pregnant women / children / MBIWD / family planning under MAGI; SSI Categorical / Categorically Needy / three Track C spend-down options under ABD; Special Income Limit, Miller Trust, spousal impoverishment, and home-equity exclusion under LTC, see Ohio Medicaid Eligibility & Income Limits.

Pathway 1, MAGI (Modified Adjusted Gross Income)

For adults 19-64, parents/caretakers, pregnant women, and most family Medicaid: applies the federal MAGI methodology under 42 CFR 435.603. Income only, no asset/resource test. Income limits (2026):1

• Group VIII (Medicaid Expansion, age 19-64): up to 138% FPL ($1,800/month single in 2026).
• Parents/Caretakers: up to 90% FPL.
• Pregnant women: up to 200% FPL.
• Children 0-18: up to 156% FPL (CHIP1, no premium) or 206% FPL (CHIP2, premium tier).

Ohio Group VIII Work and Community Engagement 1115: Federally approved February 2025; implementation 1/1/2026; estimated 62,000 disenrollments. Does NOT affect: dual-eligibles, NH residents, persons on disability, parents/caretakers of dependent children, pregnant women, persons in active SUD treatment, primary caregivers, full-time students.

Pathway 2, ABD (Aged, Blind, Disabled)

For adults 65+ or disabled per SSA standards (regardless of age): traditional non-MAGI methodology.1

• Income: $994/month single (equal to the 2026 SSI Federal Benefit Rate); $1,491/month couple.
• Resources: $2,000 single; $3,000 couple (both applying).

No income spend-down: Ohio ended its aged, blind, or disabled income spend-down on August 1, 2016, when it became a Section 1634 state. The Ohio Department of Medicaid states that from that date "individuals will no longer be able to spenddown to become eligible for Medicaid." A community-based ABD adult whose income exceeds the applicable limit cannot buy in month by month, and for institutional or HCBS-waiver coverage above the Special Income Level the mechanism is a Miller Trust. Reducing countable assets to the resource limit is a separate and still-valid step:8

1. Pay the income difference directly to ODM as a premium-like "pay-in," OR
2. Accumulate medical bills equal to the spend-down amount.

The exact spend-down figure depends on your countable income; confirm your monthly spend-down with your County Department of Job and Family Services (CDJFS). For the full breakdown of the ABD pathway and spend-down tracks, see Ohio Medicaid Eligibility & Income Limits.

1634 status (Ohio is 1634, NOT 209(b)): SSI recipients are automatically enrolled in Medicaid via SSA data exchange. Ohio became income-cap in 2014 (prior 209(b) status converted). The 209(b) states are CT/HI/IL/MN/MO/NH/ND/VA only.1

Pickle Amendment: Ohio applies federal Pickle protections to former SSI recipients who lost SSI due to Title II COLAs.

DAC (Disabled Adult Children) and Disabled Widow(er): Section 1634(c) and 1634(b) protections apply.

Section 1619(b): Working SSI recipients retain Medicaid above the SSI cash threshold (2026 OH threshold tracks federal calculation).

Pathway 3, LTC / HCBS Special Income Limit

For applicants needing nursing facility or HCBS waiver coverage:1

• Income: $2,982/month single (300% of the SSI Federal Benefit Rate in 2026); $5,964/month couple both applying.
• Resources: $2,000 single; $3,000 couple both applying. The community spouse is protected by the Community Spouse Resource Allowance (CSRA) of up to $162,660, with a floor of $32,532.9
• Home equity: Ohio applies the federal home-equity exclusion limit of $752,000 for 2026 (the federal minimum tier).1,10

Above the $2,982 income limit: Applicants must establish a Qualified Income Trust (QIT) / Miller Trust under 42 USC § 1396p(d)(4)(B) naming the State of Ohio as remainder beneficiary. ALL monthly income must be deposited into the trust each month (partial deposits fail eligibility); the trust pays out the $75 Personal Needs Allowance, health insurance premiums, the community spouse income allowance, and the remainder to the provider as patient liability.10,3

2026 Ohio Medicaid Financial Eligibility Limits

The figures below are the 2026 Ohio Medicaid financial thresholds for aged, blind, and disabled and long-term care applicants.1,9,10,3

Note: CSRA and MMMNA figures shown above are effective through 6/30/2026 and are federally re-indexed annually; verify the post-7/1/2026 figures before relying on them.

Ohio's 1915(c) HCBS Waivers

Ohio operates five 1915(c) Home and Community-Based Services waivers in 2026. Waiver applicants use the Special Income Limit ($2,982/month single in 2026) and the same $2,000 asset limit as institutional Medicaid.6,11,12

1. PASSPORT, Pre-Admission Screening System Providing Options and Resources Today

• Population: age 60+ via ODA/AAA
• Functional eligibility: nursing facility level of care (NF LOC) per ACAT
• Administration: Ohio Department of Aging (ODA) via the 12 Area Agencies on Aging (AAAs)
• Services: personal care, homemaker, adult day, home-delivered meals, PERS, transportation, skilled nursing, respite, home modification (limited), specialized equipment, IL assistance
• Financial eligibility: Special Income Limit ($2,982/month single)6
• Status: continues for non-dual or non-MyCare populations; for dual-eligibles in Next Gen MyCare counties, members are auto-converted to MyCare Ohio Waiver
• Full guide: The Ohio PASSPORT Waiver

2. Assisted Living Waiver

• Population: age 21+
• Functional eligibility: NF LOC
• Setting: licensed Residential Care Facility (RCF / assisted living)
• Slots: a defined enrollment cap, NOT an entitlement (waitlist possible); confirm current slot count and waitlist status with ODA
• Administration: ODA via AAAs
• Services: personal care, medication administration, support coordination, dining, social activities (room and board NOT covered by Medicaid; member pays room and board separately, typically through SSI or family resources)
• Full guide: Ohio Assisted Living Waiver

3. Ohio Home Care Waiver

• Population: age 18-59 (or younger), physical disability
• Functional eligibility: NF LOC
• Administration: ODM directly (not ODA)
• Services: similar to PASSPORT (personal care, skilled nursing, supplies, equipment)
• Self-direction: expanded effective 10/1/2024, C-HCAS and CD-PCS options
• Full guide: The Ohio Home Care Waiver

4. MyCare Ohio Waiver (OAC 5160-58)

• Population: dual-eligibles (Medicare + Medicaid) age 21+ enrolled in Next Gen MyCare in launched counties
• Function: capitated 1915(c) waiver bundled into Next Gen MyCare FIDE-SNP
• Services: equivalent or expanded vs. PASSPORT/AL/OHC; ALSO includes Structured Family Caregiving (SFC), C-HCAS, CD-PCS
• Administration: ODM via Next Gen MyCare carriers (Anthem, Buckeye, CareSource, Molina), carriers contract care coordinators; some contract with AAAs for case management
• Full guide: The MyCare Ohio Waiver

5. DODD Waivers (Individual Options, Level One, SELF)

• Population: persons with intellectual or developmental disabilities (I/DD)
• Administration: Ohio Department of Developmental Disabilities (DODD), covering the Individual Options, Level One, and SELF waivers
• Eligibility: requires DODD level-of-care determination (different from NF LOC); Ohio County Boards of Developmental Disabilities are the local administrators
• Services: vary by waiver (Individual Options is most flexible/comprehensive; Level One has lower budget cap; SELF is participant-directed)
• Status: NOT part of MyCare; DODD-waiver beneficiaries are excluded from Next Gen MyCare

Mainstream Ohio Medicaid Managed Care (Non-Dual)

For non-dual Ohio Medicaid recipients, multiple plans operate the mainstream Medicaid Managed Care program under Ohio's Next Generation managed care procurement. The current carrier roster (commonly including AmeriHealth Caritas, Anthem, Buckeye, CareSource, Humana Healthy Horizons, Molina, and UnitedHealthcare Community Plan) shifts with state contracting cycles, so consult the Ohio Medicaid Managed Care plan directory for the current list.

These plans cover MAGI populations (Group VIII, parents/caretakers, pregnant women, children) and ABD members not in Next Gen MyCare. UHC and Aetna remain in the Ohio Medicaid landscape via mainstream MMC and OhioRISE respectively, even though both exited Next Gen MyCare.

Plan changes: Ohio members can change mainstream MMC plans during open enrollment (90 days from initial enrollment, then annually) or with just-cause changes year-round.

OhioRISE: BH for Children and Youth

OhioRISE (Resilience through Integrated Systems and Excellence) is Ohio's specialty Medicaid managed care plan for children and youth (ages 0-20) with the most complex behavioral health needs.

• Carrier: Aetna Better Health of Ohio (continuing 2026) operates OhioRISE under contract with ODM
• Target enrollment: tens of thousands of children and youth statewide; consult ODM for the current enrollment count
• Eligibility: Ohio Medicaid child/youth + meets functional criteria (assessed by CANS, Child and Adolescent Needs and Strengths tool)2
• Services: care coordination, intensive home-based treatment, mobile response and stabilization, psychiatric residential treatment, family peer support, transition to adult services
• Bridge to adult services: at age 21, OhioRISE youth who are dual-eligible should plan Next Gen MyCare enrollment proactively; non-dual continue under mainstream MMC

The Single Pharmacy Benefit Manager (SPBM)

Ohio runs a unified pharmacy benefit across all Medicaid managed care plans (mainstream managed care, Next Gen MyCare, and OhioRISE) through a single pharmacy benefit manager under contract with ODM, with a public portal at spbm.medicaid.ohio.gov. Because the SPBM was transitioning prior-authorization portals during 2026, refill important prescriptions ahead of any announced changeover and confirm the current PA process and Help Desk number with ODM before submitting time-sensitive prior authorizations.

You can apply through any of four channels, and long-term care applicants complete an added clinical step.1

SSI applicants: SSI receipt automatically triggers Medicaid enrollment in Ohio (a 1634 state). No separate Medicaid application is needed; ODM is notified by SSA's State Data Exchange (SDX).1

Federal three-month retroactive coverage under 42 CFR 435.915 currently applies. The One Big Beautiful Bill Act (H.R. 1) will limit retroactive coverage starting 1/1/2027, with 1 month for ACA-expansion adults and 2 months for other Medicaid groups, subject to CMS implementation guidance throughout 2026.13

Estate Recovery: Ohio's Unusually Broad Reach

Ohio elects expanded estate recovery, one of the broader schemes in the country. Under ORC 5162.21 (renumbered from ORC 5111.11), Ohio's expanded estate recovery applies to both probate AND non-probate assets, broader than the federal probate-only floor that 42 U.S.C. 1396p(b) permits:4

• Transfer-on-death (TOD) accounts
• Jointly-owned property (with right of survivorship)
• Payable-on-death accounts
• Assets in living/revocable trusts
• Life estates created by the decedent
• Any other interest the decedent had at the moment before death

TEFRA Lien Authority (ORC 5162.211): Ohio has authority to place liens on property of permanently institutionalized Medicaid recipients before death (federal hardship and exemption protections still apply).

Procedure (ORC 2117.061): after the estate's representative submits the Medicaid estate recovery notice form, ODM (acting through the Attorney General's office) presents its claim no later than 90 days after receiving that form, or one year after the decedent's death, whichever is later. There is no hard 90-day cutoff; the one-year-from-death limb is a floor, so a personal representative cannot bar the claim by delaying the notice.4

Federal exemptions still apply:4

• No recovery while a surviving spouse is alive
• No recovery while a minor child or disabled child of the decedent survives
• No recovery if a sibling with equity interest who lived in the home for at least 1 year before institutionalization survives
• No recovery if a "caretaker child" (adult child living in home and providing care for at least 2 years before institutionalization) survives

Hardship Waiver: Available; petition within 30 days of estate recovery notice. Grounds include income-producing family property, substantial relative caregiving, modest estate size, equitable circumstances.

HB 318 (136th General Assembly, 2025-2026), a pending bipartisan reform sponsored by Reps. Stephens and Brennan, would narrow Ohio's recovery toward probate-only (eliminating the expanded non-probate reach) and add low-value estate waivers. It has not advanced beyond its initial Medicaid-committee referral (latest action June 4, 2025).4

Status as of May 2026: under House Medicaid Committee consideration; not enacted. Pro Seniors and Disability Rights Ohio leading advocacy.

Practical advice: For Ohio Medicaid LTSS applicants, estate recovery planning is more important than in most states. Strategies that protect from recovery in other states (TOD accounts, joint titling, revocable trusts) DO NOT protect from Ohio's expanded recovery. Consult an Ohio elder law attorney experienced in expanded recovery before estate-planning decisions.

For deeper context, see our Ohio Estate Recovery deep article and the Medicaid Estate Recovery Explained federal hub, which walks through 42 USC § 1396p(b), the 51-jurisdiction matrix, hardship-waiver standards, and the cross-state planning toolkit.

Paid Family Caregiving in Ohio

Ohio expanded paid family caregiver options materially in late 2024:12

• Effective October 1, 2024: Self-direction expanded under the Ohio Home Care Waiver
• Effective November 15, 2024: Self-direction expanded under the MyCare Ohio Waiver

Two participant-direction options:

1. Choices Home Care Attendant Service (C-HCAS), budget-flexible rates within state ranges; participant directs hiring/scheduling/training; can hire family members including spouses, adult children, grandchildren, nieces, nephews, in-laws.
2. Consumer-Directed Personal Care Service (CD-PCS), state-set rates; same family-hire scope as C-HCAS.

Structured Family Caregiving (SFC), a separate daily-care payment model under PASSPORT, MyCare Ohio, and Ohio Home Care waivers. A live-in family caregiver receives a daily rate that varies by acuity tier; confirm the current rate with your AAA case manager. Spouses are excluded under federal SFC rules; some Ohio waivers allow spouses under C-HCAS, so verify with your case manager.

All paid caregivers must:

• Pass Ohio BCI/FBI fingerprint background check
• Complete training (varies by waiver)
• Enroll as a Medicaid provider with ODM (typically 4-8 weeks)

For more on this, see Ohio Paid Family Caregiver Programs.

PACE in Ohio

McGregor PACE is the only operational PACE program in Ohio in 2026. PACE (Program of All-Inclusive Care for the Elderly) under 42 CFR Part 460 is a separate Medicare-Medicaid product with capitated payment to the PACE provider, mandatory day-center attendance, and an integrated provider team.

McGregor PACE service area: McGregor operates PACE sites across northeast Ohio (Cuyahoga and adjacent counties); consult the Medicaid.gov PACE locator for the current Ohio PACE roster and service area.

Eligibility: age 55+, nursing-facility level of care, residence in a PACE service area, and the ability to live safely in the community, per the federal PACE requirements at 42 CFR 460.150.14

PACE is mutually exclusive with Next Gen MyCare, a person enrolls in one or the other.

PACE Association of Ohio is the state's PACE coordinating body. Ohio has statutory authority for PACE expansion to additional counties; consult the Association and ODM for the current operational footprint and timelines.

If Ohio Medicaid Denies or Cuts Your Coverage

Ohio's deadline is 90 days, counted from the mailing date on the notice rather than the day it reached you. ODJFS must receive your state-hearing request inside that window.15 Federal law guarantees every Medicaid applicant and beneficiary the right to a fair hearing before the state agency, whether the dispute is about eligibility or about a specific service being reduced or ended.13 That 90 is the ceiling 42 CFR 431.221(d) puts on what a state may allow, not a floor you are owed; Ohio uses it in full, and other states set shorter windows that bind just as firmly.16

The second clock is shorter, and it decides whether coverage keeps running. If you are already enrolled and the notice says your assistance or services will be reduced, stopped, or restricted, request the hearing within 15 days of receiving that notice to hold your benefits at the prior level until a decision is issued.15 The federal protection turns on filing before the action's effective date, and a denied applicant has no benefits to continue, so this window guards coverage you already have.17

If a Next Generation managed care plan issued the denial, appeal to the plan within 60 calendar days of the date its notice of action was issued, exhaust that appeal, then request a state hearing within 90 calendar days of the plan's adverse resolution.18 That 60-day clock is the plan track, not the eligibility-denial deadline.

Find both dates on your own notice and file before the earlier one. See Ohio Medicaid Appeals and Fair Hearings for how to file, what the hearing itself involves, and what happens after a decision.

Keeping Ohio Medicaid Once You Have It

Eligibility is re-checked on a recurring cycle, and missing that step is one of the most common ways people lose coverage they still qualify for.

Ohio Medicaid must first try to renew your coverage automatically from information it already holds, and may only request documents if it cannot.19 If it does need paperwork, it must send a renewal form and give you at least 30 days from the date of the form to return it. That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, Ohio may offer the same windows but is not required to, so ask ODM what applies to you.19

If coverage does close because a form went unreturned, that is not the end of it. Federal rules require the agency to reconsider your eligibility without a new application if you return the renewal form within 90 days of the termination (required for MAGI-based coverage; a state option otherwise).19

Keep your address current, open anything from Ohio Medicaid, and return a renewal form the week it arrives. See Ohio Medicaid Recertification and Renewal for the full cycle and how to recover closed coverage.

Where to Get Help

Ohio has free counseling, ombudsman, and legal-aid resources for Medicaid and long-term care questions. Start with the state agencies below, then use your local Area Agency on Aging for in-person help.

Other support lines: Ohio Senior Medicare Patrol / Pro Seniors (800-488-6070, opt. 4); Ohio CareLine mental-health support (800-720-9616); and the 988 Suicide & Crisis Lifeline (call or text 988).

Area Agencies on Aging (12 statewide, call for in-person assessment, PASSPORT enrollment, MyCare transition help):

• AAA1 Council on Aging of Southwestern Ohio (Cincinnati), 800-252-0155
• AAA2 Area Agency on Aging PSA 2 (Dayton), 800-258-7277
• AAA3 Area Agency on Aging 3 (Lima), 800-653-7277
• AAA4 Area Office on Aging of Northwestern Ohio (Toledo), 800-472-7277
• AAA5 Ohio District 5 AAA (Ontario/Mansfield), 800-860-5799
• AAA6 Central Ohio Area Agency on Aging (COAAA, Columbus), 800-589-7277
• AAA7 Area Agency on Aging 7 (Rio Grande), 800-582-7277
• AAA8 Buckeye Hills AAA (Marietta), 800-331-2644
• AAA9 Area Agency on Aging Region 9 (Cambridge), 800-945-4250
• AAA10A Western Reserve AAA (Cleveland), 800-626-7277
• AAA10B Direction Home Akron Canton (Uniontown), 800-421-7277
• AAA11 Direction Home Eastern Ohio (Youngstown), 800-686-7367

Legal aid and advocacy: Pro Seniors Inc. (Cincinnati, statewide elderly legal services, 513-345-4160), Disability Rights Ohio (disabilityrightsohio.org), and your regional legal-aid office (Legal Aid of Western Ohio, Legal Aid Society of Cleveland, Southeastern Ohio Legal Services, or Community Legal Aid Services in Akron/Canton/Youngstown). For finding nursing-facility, assisted-living, and HCBS providers, LeadingAge Ohio and the Ohio Health Care Association keep member directories.

Federal: Medicare, 800-633-4227; national SHIP locator, shiphelp.org.21

Pending Ohio Policy

These items were pending as of May 2026; verify current status with ODM before relying on any of them in a single case.4,2

1. HB 318 (136th GA), estate recovery reform (narrow toward probate-only with low-value waivers); Pro Seniors and Disability Rights Ohio leading advocacy; in the House Medicaid Committee as of May 2026, not enacted.
2. SUD 1115 demonstration renewal, original demonstration extended through 12/31/2025 with renewal pending CMS approval as of May 2026; verify status against ODM and the CMS Section 1115 demonstrations page before relying on this in a single-case timeline.
3. Group VIII Work and Community Engagement 1115, federally approved February 2025; implementation 1/1/2026; estimated 62,000 disenrollments. Does NOT affect dual-eligibles, NH residents, persons on disability.
4. Phase 2 Next Gen MyCare statewide rollout, continues through August 2026; carrier provider networks in Phase 2 counties continue contracting through summer 2026.
5. PACE expansion, statutory authority for Franklin/Hamilton/Montgomery/Lucas/Trumbull/Ashtabula/Mahoning counties; no firm operational dates as of May 2026.
6. CY2027 federal D-SNP timing, a second integration trigger on 1/1/2027 (one D-SNP per state per parent organization for full-benefit dual-eligible-only plans), with the federal D-SNP look-alike threshold tightening further. Confirm the exact CMS parameters before relying on them.
7. H.R. 1 retroactive Medicaid coverage limits effective 1/1/2027, subject to CMS implementation guidance.

Learn More

Eligibility, applying, and financial planning

Long-term care and HCBS waivers

Managed care and statewide

Find personalized help navigating Ohio Medicaid 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.