In 2026, the Ohio PASSPORT waiver pays for in-home care for Ohioans age 60 and older who would otherwise need a nursing facility. To qualify, a person must meet all nine criteria in Ohio's PASSPORT eligibility rule, chief among them being 60 or older at enrollment, meeting a nursing facility level of care, and being eligible for Ohio Medicaid. PASSPORT (Pre-Admission Screening System Providing Options and Resources Today) is Ohio's Medicaid Home and Community-Based Services (HCBS) waiver for older adults, and it covers personal care, homemaker help, adult day, meals, and other community supports. It is authorized under Ohio Administrative Code Chapter 5160-31 and run day to day by the Ohio Department of Aging (ODA) through Ohio's Area Agencies on Aging (AAAs) under an agreement with the Ohio Department of Medicaid (ODM).

This guide is the operational deep-dive on PASSPORT, distinct from the Ohio HCBS waivers overview and the Ohio Medicaid application guide. It walks through:

  • The nine eligibility criteria, and the four (age, setting, level of care, and finances) that decide most cases.
  • The in-home assessment and how the level-of-care determination works.
  • The full PASSPORT service package and the per-person monthly cost cap.
  • How the service plan is built, the role of the AAA case manager, and how to appeal a denial or reduction.

Key Takeaways

  • PASSPORT is the Ohio Medicaid waiver for older adults in the community. Among the nine criteria in OAC 5160-31-03, a participant must be age 60 or older at enrollment, meet an intermediate or skilled nursing facility level of care, and be determined eligible for Ohio Medicaid. Authority: OAC Chapter 5160-31.
  • Administered by ODA through Area Agencies on Aging. ODA delegates one or more of its administrative duties to its designees. Under OAC 173-39-01, those designees include the area agencies on aging plus Catholic Social Services of the Miami Valley (the rule states the list as inclusive, not exhaustive). The AAA handles intake, the in-home assessment, the service plan, and case management. Statewide intake: 1-866-243-5678.
  • Level of care turns on care needs, not a diagnosis. Under OAC 5160-3-08, the intermediate level calls for needs such as help with at least two activities of daily living, help with one plus medication administration, a skilled nursing or rehab service, or 24-hour support to prevent harm from a diagnosed cognitive impairment.
  • The service package covers 21 services. Personal care, homemaker, adult day, home-delivered meals, non-medical transportation, personal emergency response systems, home modifications, out-of-home respite, waiver nursing, structured family caregiving, and the Choices home care attendant service are among them. The mix is individualized in the service plan.
  • Each plan of care has a monthly cost limit of $14,700. Under OAC 5160-31-03, the waiver services in a person's plan at enrollment cannot cost more than $14,700 per month, and the ongoing plan may go above that only with the Ohio Department of Aging's approval, which is why the waiver typically does not fund 24-hour personal care in the home.
  • Family caregivers can be paid in some cases. Through participant direction (the Choices Home Care Attendant Service or Consumer-Directed Personal Care Service), the participant is the employer and hires their own attendant. A spouse can be paid only through the conditional pathway in OAC 5160-44-32. See /caregiver/ohio/consumer-direction.
  • Appeals have a 90-day window, and a MyCare plan appeal comes first. For an agency action (an eligibility or fee-for-service decision), ODJFS must receive the State Hearing request within 90 days of the notice's mailing date. If the participant's services run through a MyCare Ohio plan, they must generally exhaust the plan's own appeal first, filed with the plan within 60 calendar days of its notice of action, and then have 90 calendar days from that plan resolution to request a State Hearing. Request it by calling or writing your county job and family services office, or in writing to the ODJFS Bureau of State Hearings.

Who PASSPORT Serves

PASSPORT serves older Ohioans who, without community-based services, would qualify for nursing facility placement: a person must be age 60 or older and meet an intermediate or skilled nursing facility level of care. The common thread: the person could be in a Medicaid nursing facility bed but lives in the community instead, because PASSPORT funds the supports that make community living safe.

In practice, PASSPORT serves three rough situations:

  1. The frail older adult who lives alone and needs help with personal care, meals, medication management, and household tasks to stay home safely. The trigger is often a hospitalization, a fall, a stroke, or a slow decline a family or physician notices.
  2. The older adult who lives with family whose relatives provide the primary care but need paid supplements (respite, adult day, personal care) so the family caregiver can work, sleep, or recover. Here PASSPORT supplements informal care rather than replacing it.
  3. The older adult with cognitive impairment whose family manages dementia care at home and needs adult day, respite, and oversight to maintain the home placement. For dementia-specific guidance, see /caregiver/ohio/dementia-care.

Ohio PASSPORT Waiver Eligibility in Detail

Ohio's PASSPORT rule, OAC 5160-31-03, lists nine criteria, and an applicant must meet all of them. Four do most of the sorting: age, setting, nursing facility level of care, and Medicaid financial eligibility. The other five: the needed services aren't readily available from another source at the level required to live in the community; the person's health-related needs can be safely met in a home and community-based setting, as ODA or its designee determines; the person agrees to help develop a person-centered services plan; the person needs and agrees to receive at least one waiver service each month (or, for someone who needs continuous nursing for more than four hours, at least one waiver service a year plus monthly health-and-welfare monitoring by the case manager); and the person isn't enrolled in one of the programs listed under Setting below. Enrollment also requires an open PASSPORT slot within the CMS-authorized limit for the waiver year.

Age

The participant must be age 60 or older at the time of enrollment. Adults under 60 with disabilities are served by the Ohio Home Care Waiver (OHCW) under OAC Chapter 5160-46 instead of PASSPORT.

Setting

The participant must live in a setting that has the home and community-based characteristics set out in OAC 5160-44-01 and that is not a hospital, nursing facility, intermediate care facility for people with intellectual disabilities, or other licensed or certified facility or group living arrangement. So PASSPORT does not serve nursing facility residents, and residents of a licensed residential care facility look to the Assisted Living Waiver under OAC Chapter 5160-33 instead. A nursing facility resident planning to move home can ask the AAA about PASSPORT during discharge planning. PASSPORT enrollment is also mutually exclusive: a participant cannot be simultaneously enrolled in the state-funded PASSPORT or assisted living components, another Medicaid HCBS program, the Residential State Supplement program, or PACE.

Financial Eligibility

PASSPORT requires Ohio Medicaid financial eligibility at the institutional level, which means:

  • Income at or below the Special Income Level, set at 300 percent of the SSI federal benefit rate, which is $2,982 per month for 2026. An applicant over that limit can use a Miller Trust (Qualified Income Trust) to establish eligibility. For the income limit and Miller Trust mechanics, see /medicaid/ohio/eligibility-income-limits.
  • Countable resources at or below $2,000 for a single applicant ($3,000 if both spouses apply). For a married couple with one spouse applying, the community-spouse resource allowance under federal spousal-impoverishment rules protects part of the couple's resources for the spouse at home.
  • No improper transfers in the 60-month look-back period. For a waiver applicant, giving away assets for less than fair market value on or after the look-back date (sixty months before the date they both applied for Medicaid and asked for waiver enrollment) is presumed improper and leads to a restricted Medicaid coverage period, when Medicaid won't pay for their long-term care. The rule lists exceptions, and it ties these provisions to eligibility under the Special Income Level, so ask the county office how they apply to you.
  • Home equity at or below $752,000 for 2026, the federal home-equity exclusion limit Ohio applies.

For couples, the community spouse resource allowance is the highest-stakes number: ODM's 2026 standards set it between $32,532 and $162,660, and a fair hearing or a court order can set it higher. See /medicaid/ohio/how-to-apply for the application guide.

Clinical Eligibility: Nursing Facility Level of Care

PASSPORT requires that the applicant meet an intermediate or skilled nursing facility level of care under OAC rule 5160-3-08, meaning that without waiver services they would need nursing facility services. The Ohio Department of Medicaid or its designee makes the determination from the ODM 03697 Level of Care Assessment, whose recommendation section is reserved for PASSPORT Administrative Agency staff, and the request needs a signed certification from a physician, nurse practitioner, or physician assistant. The assessment looks at:

  • Activities of daily living (ADLs): bathing, dressing, transferring, toileting, eating, and continence, each rated by how much help is needed.
  • Instrumental activities of daily living (IADLs): meals, medication management, housekeeping, laundry, transportation, shopping, and managing finances.
  • Cognitive function: memory, decision-making, and the ability to understand and be understood.
  • Behavioral health: behaviors that affect safety or care, mood symptoms, and sleep disruption.
  • Medical complexity: chronic conditions, medications, recent hospitalizations, falls, skin integrity, nutrition, and pain.
  • Informal support and environment: the capacity of family, friends, and neighbors to provide care, plus home safety, accessibility, and isolation.

What decides it is care need, not a diagnosis. Under OAC 5160-3-08, the intermediate level requires needs beyond Ohio's lower protective level of care plus at least one of: help with at least two activities of daily living; help with one activity of daily living plus help with medication administration; at least one skilled nursing or skilled rehabilitation service; or 24-hour support to prevent harm because of a cognitive impairment diagnosed by a physician or licensed professional. The skilled level requires a skilled nursing service seven days a week, or a skilled rehabilitation service five days a week, along with an unstable medical condition.

This is why two people with the same diagnosis can have different outcomes. Dementia meets the intermediate level when it creates a need for 24-hour support to prevent harm, or comes with the daily-living needs above; a milder case may not. Separately, PASSPORT's own rule asks whether the needed services are readily available from another source, which is where help a family already gives can come into play.

The In-Home Assessment Process

The PASSPORT assessment is typically done at the applicant's home by an assessor working for, or under contract with, the AAA handling the case. It moves through four stages, from the first phone call to the written level-of-care determination.

1
Step 1

Initial phone screening

When a family or referring source (a hospital discharge planner, physician, hospice agency, or family member) calls the AAA at 1-866-243-5678, an intake worker conducts a phone screening covering basic demographics, broad clinical and functional needs, and the reason for the call. The screening is a triage step, not the full assessment, and decides whether to schedule an in-home visit.

2
Step 2

Scheduling

If the screening suggests the applicant may meet PASSPORT eligibility, the AAA schedules an in-home assessment. Scheduling times vary by AAA workload, so families should ask their AAA for the current local timeline. For a hospital-discharge applicant on a short clock, tell the AAA the expected discharge date at the first call.

3
Step 3

The in-home assessment

The assessor observes the home for safety, accessibility, and basic supplies; interviews the applicant directly about each ADL, IADL, cognitive, and behavioral domain; observes mobility, balance, and transfers during the visit; interviews family or informal caregivers if present about the help they provide; reviews medications, recent medical encounters, and available clinical documents; and documents informal-support gaps and clinical risks. Arrange for a family member or representative to be there; for an applicant with cognitive impairment that matters most, because the applicant may not accurately describe their own functional level.

4
Step 4

Determination

The assessor compiles the assessment score and clinical narrative and submits it for the level-of-care determination, which is communicated to the applicant in writing. An adverse determination comes with information on the applicant's hearing rights. If the applicant does meet the level of care, the AAA proceeds to service-plan development.

What to Do If You Disagree With the Assessment

If the family believes the assessment did not capture the applicant's functional limitations, they have options:

  • Request a reassessment through the AAA with new clinical information or observations
  • Submit physician documentation elaborating on functional limitations the assessment may have under-captured
  • Ask for an in-person determination if the decision was made by desk review or phone; under OAC 5160-3-14 it takes place within ten calendar days of the request
  • File a State Hearing appeal within 90 days of the adverse notice's mailing date and present the case to a State Hearing Officer

For applicants with cognitive impairment, documented evidence of specific incidents (wandering, medication errors, kitchen safety failures, falls, missed meals) strengthens the case substantially.

The Person-Centered Service Plan

Once the level of care is established and the applicant is financially eligible, the AAA case manager and the applicant (or representative) develop the person-centered service plan, the operational core of PASSPORT participation. The plan draws from the 21 covered services defined in OAC Chapter 173-39 and is bounded by the individual cost cap.

The service plan documents the participant's goals, identified needs in each functional domain, authorized services with specific hours or units, the providers chosen from the AAA's list, the budget measured against the cost cap, backup planning, and a reassessment schedule. Each service is authorized in specific units (hours per week, meals per month, days of adult day, modifications by item) based on assessed need and participant preference within the cap.

PASSPORT is built around participant choice. Within the authorized budget, the participant chooses the mix of services, the provider for each, the agency-employed or consumer-direction model for personal care, and the schedule. The plan is not static: federal waiver rules require the participant's level of care to be reevaluated at least once a year, and the participant can ask for a revision any time needs change, whether from a hospitalization, the loss or addition of an informal caregiver, a move, a provider change, or a concern about service adequacy.

The PASSPORT Service Package

The full PASSPORT service package under OAC Chapter 5160-31 comprises 21 covered services, each defined in OAC Chapter 173-39. The most-used services include:

Personal Care Services

Personal care covers help with ADLs (bathing, dressing, transferring, toileting, eating, continence) and IADLs (meal preparation, medication reminders, light housekeeping, laundry). It is delivered either by aides employed by ODA-certified provider agencies, or by an attendant the participant hires through participant direction, with the participant as employer of record and a financial management service acting as their agent. The hours authorized depend on assessed need, available informal support, and the cost cap.

Homemaker Services

Homemaker services cover housekeeping, laundry, shopping, meal preparation, and other instrumental tasks the participant cannot do alone. Homemaker is conceptually distinct from personal care: homemaker is about the home environment, personal care is about the person. In practice the same worker often provides both, with the agency billing the appropriate code for each task.

Adult Day Services

Adult day services provide structured group programming during the day at an adult day center, typically for older adults with significant supervision needs (often due to dementia) who live with a family caregiver who is away during the day. Services include socialization, supervision, meals, activities, transportation, and in some adult day health centers, limited skilled nursing.

Home-Delivered Meals

PASSPORT covers home-delivered meals for participants who cannot prepare meals safely, and the package separately lists alternative meals. Ask the case manager which local meal providers serve your area and how often they deliver.

Other Core Services

The package also includes non-medical transportation to medical appointments, adult day, and other authorized destinations; personal emergency response systems (a wearable help button with monitoring); home modifications such as ramps, grab bars, and bathroom changes, funded up to a yearly per-person cap; out-of-home respite to relieve the primary informal caregiver; waiver nursing; nutrition consultation; social work or counseling; home maintenance and chore; home medical equipment and supplies; community integration; community transition; enhanced community living; structured family caregiving; and vehicle modifications. Ohio's March 2026 waiver amendment application proposed raising the home modification cap from $10,000 to $15,000 per calendar year per person and adding vehicle modifications; that document is Ohio's request to CMS, so confirm the current cap with the case manager. For respite specifics in Ohio, see /caregiver/ohio/respite-care.

Consumer-Direction Services

Within PASSPORT, the participant can choose participant direction through the Choices Home Care Attendant Service or Consumer-Directed Personal Care Service. The participant is the employer and the attendant is the employee: the participant recruits, hires, fires, supervises, and sets the schedule, can name a representative to help with employer duties, and works with a financial management service that acts as their agent. A spouse can be the paid worker only if no other willing and able provider is available and ODA or its designee has determined the participant's health and safety needs can be ensured, and then generally for no more than 40 hours a week, under OAC 5160-44-32. For the operational mechanics, see /caregiver/ohio/consumer-direction.

The Plan-of-Care Cost Cap

The cost cap is the single most important constraint on PASSPORT service planning. Under OAC 5160-31-03, the waiver services in a person's plan at enrollment cannot cost more than $14,700 per month, and the ongoing cost of the plan may not exceed that limit unless the Ohio Department of Aging approves it. The individual cap sits underneath the federal cost-neutrality test every 1915(c) waiver must satisfy: Ohio must assure the federal Centers for Medicare and Medicaid Services (CMS) that average per capita expenditure under the waiver will not exceed 100 percent of what the corresponding institutional level of care would have cost had the waiver not been granted. Note the direction of that test. It is a ceiling on average spending across the whole waiver population, not a requirement that each individual plan of care cost less than a nursing facility bed.

Practical implication: PASSPORT typically cannot fund 24-hour personal care in the home, because around-the-clock attendant hours at Medicaid rates would push a plan toward or past the cap. For participants needing 24-hour supervision, the realistic options are:

  1. Combine PASSPORT with substantial family or informal caregiving (the most common pattern)
  2. Ask whether ODA will approve an ongoing plan above the limit, which the rule allows once the participant is enrolled
  3. Switch to PACE where a PACE program serves the area (PACE provides integrated medical and long-term care for nursing-facility-eligible older adults, but PACE and PASSPORT cannot be combined, so this means leaving PASSPORT)
  4. Transition to assisted living under the Assisted Living Waiver if that setting fits
  5. Transition to a nursing facility if community placement is no longer feasible

For families discovering that PASSPORT cannot fund what they expected, the case manager is the best resource for understanding the cap and the trade-offs. Sometimes a service-plan revision (more adult day, less personal care, or the reverse) fits the cap better; sometimes the right answer is a setting transition.

The Role of the AAA Case Manager

The AAA case manager (some AAAs use "care manager" or "service coordinator") is the participant's primary contact for the duration of PASSPORT participation. Under OAC 173-39-01, the case manager is a registered or licensed person that ODA's designee (in practice, the AAA) employs to plan, coordinate, monitor, evaluate, and authorize services for individuals enrolled in ODA-administered programs. Responsibilities include:

  • Coordinating the assessment and annual clinical reassessment
  • Developing and revising the service plan
  • Authorizing services and providers
  • Monitoring service-delivery quality and investigating provider complaints
  • Coordinating with the primary care physician, home health agency, hospital discharge planners, hospice, and family caregivers
  • Responding to changes in clinical condition or living situation
  • Connecting the participant to resources outside PASSPORT (legal aid, food assistance, senior centers, support groups)
  • Advocating for the participant when needs exceed the cost cap

Case management is a high-volume role in Ohio's HCBS system, so most contact with the case manager is by phone or scheduled visit rather than on demand. Families should know their case manager's name and direct contact information and should reach out promptly when issues arise.

When the Participant and Family Disagree With the Case Manager

Disagreements between families and case managers are common in HCBS waiver case management, usually over the hours of personal care authorized, the choice of services within the cost cap, the choice or quality of providers, the frequency of reassessment, consumer-direction decisions, or transitioning to a higher level of care.

The first step is always a direct conversation with the case manager. If that does not resolve it, the participant can ask to speak with the case manager's supervisor at the AAA. Escalation paths include:

For service reductions or terminations the participant believes are wrong, the State Hearing is the formal due-process pathway, decided by the ODJFS Bureau of State Hearings. Request it by calling or writing your county job and family services office, by writing to the Bureau at PO Box 182825, Columbus, Ohio 43218-2825, or by mailing or faxing ((614) 728-9574) the request form that comes with the notice. Only the participant can ask by phone; a request someone else makes must be in writing, with a statement signed by the participant naming them as representative. The Bureau's toll-free line, 1-866-635-3748, is where you arrange to join the hearing by phone and ask about continuing benefits. Two timing rules matter, and they are different:

  • 90 days to appeal. For an agency action, ODJFS must receive the request within 90 days of the notice's mailing date. If services run through a MyCare Ohio plan, the participant must generally exhaust the plan's internal appeal first (filed with the plan within 60 calendar days of its notice of action) and then has 90 calendar days from that plan resolution to request the State Hearing.
  • 15 days to keep benefits running. For an agency action, ODJFS tells beneficiaries to request the hearing within 15 days of the notice to keep benefits while the appeal is pending. In a MyCare plan, benefits continue only if the plan appeal is filed within 15 days of the plan's notice, involves ending or reducing previously authorized services, the services were ordered by an authorized provider, and the authorization period hasn't run out; continuation then stops if the participant doesn't request the State Hearing within 15 days of an adverse plan decision. Be aware of the trade-off: if continued benefits are paid and the participant loses, they may have to repay benefits they were not eligible to receive (in managed care, ODM decides whether the plan recovers that cost).

How the Ohio PASSPORT Waiver Compares to Other Long-Term Care Options

PASSPORT is one option in Ohio's long-term services and supports menu. The table below lines up the adjacent programs by who they serve and what they cover.

Option Who it serves Age Setting What it covers
PASSPORT Older adults who meet nursing facility level of care 60+ Home or community In-home personal care, homemaker, adult day, meals, respite, modifications
Assisted Living Waiver Residents of a Medicaid-participating Residential Care Facility Adults Licensed Residential Care Facility Assisted living services (not room and board)
Ohio Home Care Waiver People with disabilities under 60 0-59 Home or community Home-based personal care and nursing
MyCare Ohio Waiver Full-dual eligibles (statewide after the 2026 rollout) 21+ Home or community PASSPORT-style HCBS through an integrated plan
Nursing facility Medicaid People for whom community living is no longer feasible Varies Nursing facility Institutional long-term care
PACE Nursing-facility-eligible adults living in a PACE service area 55+ Home and PACE center Integrated medical and long-term care

The Assisted Living Waiver pays a licensed residential care facility for its assisted-living services but never for room and board. The Ohio Home Care Waiver serves Ohioans from birth through age 59. PACE requires being 55 or older, needing a nursing facility level of care, and living in a PACE program's service area.

Choosing the right pathway depends on age, clinical needs, finances, family capacity, and geography. The AAA case manager can advise on the trade-offs, and an Ohio elder law attorney is often helpful on the financial planning side.

How PASSPORT Relates to MyCare Ohio

For full-dual eligibles (Medicare plus Medicaid) in a MyCare Ohio plan, waiver services run through the MyCare Ohio Waiver instead. ODM states that a MyCare Ohio member who gets waiver services through PASSPORT is enrolled in the MyCare Ohio waiver, with the same benefits, or more, available. One plan is responsible for the member's Medicare and Medicaid benefits, including long-term care services, and a member on a waiver may have both a plan care coordinator and a waiver service coordinator, who work together.

In 2026 Ohio replaced the original MyCare Ohio demonstration with Next Generation MyCare, structured as Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) for full-duals age 21 and older. ODM launched it in the 29 original MyCare counties on January 1, 2026, and rolled it out in the rest of Ohio from April 1 to August 1, 2026; ODM's August 2026 member FAQ says the program is now implemented across Ohio. Four plans were awarded; three are open to new members statewide (Anthem Blue Cross and Blue Shield, CareSource, and Molina Healthcare of Ohio), while Buckeye Health Plan is not an option for new members in the 2026 plan year, though a current Buckeye member who wants to keep the plan needs to do nothing. This isn't a program you apply to: people who meet the criteria are in it once it reaches their county, and anyone who didn't pick a plan is automatically enrolled in one. A person is not enrolled if they are already in PACE, a Developmental Disabilities waiver, or an Intermediate Care Facility, or have other health insurance covering both inpatient hospital stays and doctor visits. So a full-dual PASSPORT participant who meets those criteria should now expect services to run through a MyCare plan rather than directly through the AAA. Confirm your own status with the case manager, since it changes who authorizes services and where an appeal is filed first.

How PASSPORT and Medicare Home Health Differ

Families often confuse PASSPORT with Medicare home health. They are different programs that can run at the same time for the same person.

Feature PASSPORT Medicare home health
Payer Ohio Medicaid (HCBS waiver) Medicare
Purpose Long-term personal care, homemaker, adult day, respite, community supports Short-term skilled nursing, therapy, and aide service
Duration Ongoing for as long as eligible Episodic, tied to a skilled need
Homebound required No Yes
Typical user Older adult needing daily living support Patient recovering from a hospital or clinical event

The Medicare side has its own gate. To qualify for Medicare home health, the beneficiary must be under a practitioner's plan of care, need part-time or intermittent skilled nursing or therapy, be certified as homebound (42 CFR 409.42), and use a Medicare-certified agency. PASSPORT imposes none of those conditions. So a PASSPORT participant who has a qualifying skilled-need episode (post-hospital wound care, post-stroke therapy) can receive Medicare home health concurrently with PASSPORT, and PASSPORT's personal care hours are separate from Medicare's home health aide visits. Medicare home health does not cover homemaker services unrelated to the care plan, or personal care when that is the only care the person needs. For more, see /care-types/ohio/home-care-vs-home-health.

What PASSPORT Does Not Cover

To set expectations clearly, PASSPORT does not pay for:

  • Room and board (housing and food come out of the participant's own income; the SIMNA, $1,939 per month for 2026, is the first amount Ohio sets aside for the participant's own maintenance needs before patient liability is figured)
  • Custodial nursing facility care (that is institutional Medicaid)
  • Assisted living facility room and board (the Assisted Living Waiver covers services, not housing)
  • Medical services Medicare or Medicaid pays directly (billed under standard coverage, not the waiver)
  • Acute hospital care, prescription drugs, or physician services (standard Medicaid or Medicare)
  • 24-hour one-on-one personal care in most cases (the $14,700 monthly cost limit typically prevents it unless ODA approves a higher ongoing plan)
  • Family caregiver wages outside the consumer-direction structure (informal family caregiving is not paid unless the family member becomes a paid worker through consumer direction or structured family caregiving)

Operational Mistakes That Hurt PASSPORT Participants

Families regularly run into preventable problems on PASSPORT. The most common:

  1. Underutilizing authorized services. A participant authorized for more personal care hours than the agency can staff often accepts the shortfall instead of pushing for the full authorization or requesting a service-plan change.
  2. Not understanding the cost limit. Families ask for more hours and are told no without learning that the $14,700 monthly limit is the constraint, that a service-mix reshuffle can sometimes free up budget, and that ODA can approve an ongoing plan above the limit.
  3. Failing to use consumer direction when family caregivers exist. Many families provide uncompensated care while not enrolling in consumer direction, which could pay the caregiver legally. See /caregiver/ohio/consumer-direction.
  4. Missing the annual reassessment. The annual reassessment is the formal review point for the plan. Families who skip or under-prepare for it miss the chance to request needed changes.
  5. Not communicating clinical changes promptly. When a participant's condition changes, the case manager needs to know to revise the plan. Delay delays the service adjustment.
  6. Confusing PASSPORT with Medicare home health. They serve different needs and can coexist, but they are not the same program.
  7. Not appealing adverse decisions. A PASSPORT denial or disenrollment is not final: the notice explains the participant's State Hearing rights, and requesting a hearing takes a call or letter to the county office.,

Frequently Asked Questions

How do I apply for PASSPORT?

Call 1-866-243-5678 to reach the Area Agency on Aging serving your county. The AAA conducts a phone screening, schedules an in-home assessment, refers the financial application to your County Department of Job and Family Services (or helps directly), and coordinates the next steps. Timelines vary by county and by how quickly financial documentation comes together. For the full procedural guide, see /medicaid/ohio/how-to-apply.

Is there a waitlist for PASSPORT?

Ohio's waiver application states that PASSPORT "is open to all eligible individuals," but enrollment also requires an open slot within the CMS-authorized limit for the waiver year. Ohio's March 2026 amendment application sets that authorized capacity at 39,807 unduplicated participants a year. That is a capacity figure, not a count of people currently enrolled, and the state can amend it. For current PASSPORT availability in your county, ask the AAA directly.

How much does PASSPORT cost?

Because participants remain in their own homes, PASSPORT does not pay for or charge room and board; housing and food come out of the participant's own income. Participants with income are, however, subject to post-eligibility treatment of income, commonly called patient liability: the rule subtracts a set of allowances from the participant's income, and what remains goes toward the cost of care.

For a PASSPORT participant, the first allowance is the Special Individual Maintenance Needs Allowance (SIMNA), defined at OAC 5160:1-6-07.1(J)(2) as 65 percent of the Special Income Level. ODM publishes the 2026 SIMNA as $1,939 per month, effective January 1, 2026, and a participant with earned income may keep up to an additional $65 of that earned income. After the SIMNA, the rule subtracts, in order, an allowance for a community spouse, an allowance for dependent family members, health insurance premiums and cost-sharing, medical expenses Medicaid doesn't cover, and, for someone with a Miller trust, a payment to administer it; only the remainder, rounded down to the nearest dollar, is patient liability. The SIMNA is set aside for the participant's own maintenance needs in the community. It is a post-eligibility deduction, not a financial-eligibility threshold, and it is a different figure from the $75 personal needs allowance for a nursing facility resident. The participant gets written notice of the patient liability amount, explaining how to request a hearing if they disagree. Services beyond the authorized plan are out of pocket if paid privately.

Can my parent use PASSPORT and Medicare home health at the same time?

Yes. They are different programs that can coexist: PASSPORT covers long-term community supports, while Medicare home health covers short-term skilled nursing and therapy for homebound patients with a skilled need. A PASSPORT participant with a qualifying skilled-need episode can receive Medicare home health concurrently. See /care-types/ohio/home-care-vs-home-health.

How many hours of personal care can PASSPORT authorize?

There is no fixed hours-per-week limit; PASSPORT authorizes hours based on assessed need within the $14,700 monthly cost limit, which ODA can approve exceeding for an ongoing plan. Adult day, homemaker, and respite fill additional needs. Around-the-clock personal care is uncommon because the limit typically does not allow it. A participant who thinks an authorization is too low should ask the case manager to walk through the cap calculation.

Can a family member be paid to provide PASSPORT services?

In some cases, yes, through two routes. With participant direction (the Choices Home Care Attendant Service or Consumer-Directed Personal Care Service), the participant is the employer and hires their own attendant, and a financial management service acts as their agent. With structured family caregiving, an ODA-certified agency employs or contracts a caregiver who lives with the participant. Spouses, and other relatives with legal decision-making authority, can be paid only under the separate criteria in OAC 5160-44-32. A caregiver paid through a 1915(c) waiver who shares the participant's home as their primary residence may be able to exclude those payments from federal gross income under IRS Notice 2014-7. For the full guide, see /caregiver/ohio/consumer-direction.

What happens if my parent's condition gets worse and they need more help?

Contact the AAA case manager promptly to request a service-plan review. The case manager assesses whether the authorized hours and service mix are adequate, whether a new assessment is needed, and whether the cost cap permits more services. If the cap is the constraint, the case manager will discuss alternatives: more family or informal support, private-pay supplements, an Assisted Living Waiver or nursing facility transition, or PACE if available. Revisions can be made any time, not just at the annual reassessment.

Can my parent stay on PASSPORT if they move to a different county in Ohio?

Yes. PASSPORT is a statewide waiver. The AAA handling the case changes to the one serving the new county, but the participant stays on PASSPORT. Notify the case manager well before the move so the case transfers smoothly. If the participant moves out of Ohio, PASSPORT eligibility ends, because Medicaid HCBS waivers are state-specific; they would apply for the comparable program in the new state.

What happens to PASSPORT if my parent moves into a nursing facility?

PASSPORT requires living in a home and community-based setting rather than a nursing facility, and a participant who stops meeting the criteria is disenrolled, with notice of hearing rights. A long-term nursing facility resident moves to institutional Medicaid, which is administered separately. For a hospital admission or a short rehab stay, tell the case manager right away and ask how it affects enrollment and services. For longer stays that may become permanent, the case manager and family work through the transition together.

Can I appeal a PASSPORT denial or service reduction?

Yes. For an agency action, ODJFS must receive the State Hearing request within 90 days of the notice's mailing date. Request it by calling or writing your county job and family services office, or by writing to the ODJFS Bureau of State Hearings; the Bureau's toll-free line, 1-866-635-3748, is for joining the hearing by phone and asking about continuing benefits. If the participant's services run through a MyCare Ohio plan, they must generally exhaust the plan's internal appeal first, filed with the plan within 60 calendar days of its notice of action, and then have 90 calendar days from that resolution to request the State Hearing. To keep existing services running during the appeal, request the hearing within 15 days of an agency notice; in a MyCare plan, file the plan appeal within 15 days of the plan's notice, and stricter conditions apply (see the 15-day rules above). A participant who loses may have to repay benefits they were not eligible to receive. Free legal help is available through the Ohio Legal Help network and Pro Seniors. Documentation from the participant's physician about functional limitations strengthens appeals that turn on clinical evidence.

Next Steps for Ohio Families

For families considering PASSPORT, the path from first call to an active service plan runs through these steps:

1
Step 1

Call the local AAA

Dial 1-866-243-5678 to reach the Area Agency on Aging serving your county and request a screening.

2
Step 2

Schedule the in-home assessment

Prepare by gathering medical documentation, listing current medications, and noting functional limitations the assessor should see.

3
Step 3

Begin the financial application in parallel

Apply online at benefits.ohio.gov, by phone at 1-800-324-8680, in person at your County Department of Job and Family Services, or by mail, using form ODM 07216 with its Appendix E for long-term care. Gather records covering the 60-month look-back.

4
Step 4

Consider participant direction

If someone the participant trusts is willing and able to be the paid attendant, weigh the participant-directed option during planning.

5
Step 5

For couples, ask how the community spouse's share is figured

Before applying, ask the county office how the community spouse resource allowance will be calculated, and remember that a fair hearing can raise it.

6
Step 6

Engage with the service-plan development

Stay involved so the authorized service mix matches actual needs.

7
Step 7

Stay in touch with the case manager

As circumstances change, reach out and request plan revisions promptly.

For broader context on Ohio Medicaid and HCBS waivers, see /medicaid/ohio and /medicaid/ohio/hcbs-waivers.

Use these free contacts to apply, ask coverage questions, appeal a decision, or reach dementia support and legal help.

Area Agency on Aging (statewide line) Reaches the Area Agency on Aging serving your community to start a PASSPORT screening. 1-866-243-5678https://dam.assets.ohio.gov/aging.ohio.gov/AAA-map.pdf
Ohio Medicaid Consumer Hotline Apply for Ohio Medicaid by phone, with staff help completing the application. 1-800-324-8680https://www.ecfr.gov/current/title-42/section-435.907
Ohio Department of Aging The state agency responsible for daily PASSPORT operations. 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
ODJFS Bureau of State Hearings Toll-free line for joining a hearing by phone and asking about continuing benefits. Request the hearing itself through your county office or in writing. 1-866-635-3748https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-431/subpart-E/subject-group-ECFR9c33e6014c7a689/section-431.230
Pro Seniors Free legal help for Ohio older adults on selected matters. www.proseniors.org
Ohio Legal Help Statewide legal-aid referral and self-help resources. www.ohiolegalhelp.org
Alzheimer's Association 24/7 Helpline Round-the-clock support for families managing dementia care. 1-800-272-3900https://codes.ohio.gov/ohio-revised-code/section-173.42

Learn More

MedicaidOhio Medicaid Programs OverviewOhio Medicaid in 2026: eligibility pathways and income limits, HCBS waivers, the Next Gen MyCare transition, estate recovery, and how to apply, explained. 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 Home Care WaiverHow the Ohio Home Care Waiver works in 2026: birth-to-59 nursing-facility eligibility, ODM administration, the service package, and PASSPORT at age 60. MedicaidOhio Assisted Living WaiverWhat the Ohio Assisted Living Waiver covers, who qualifies, and what residents pay: room and board is capped at $944 a month in 2026, after a $50 cushion. MedicaidOhio Medicaid Eligibility and 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. 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 PASSPORT 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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