This page is Ohio-specific. Medicaid long-term care rules vary significantly by state. See our national Medicaid Waivers Explained guide if you're elsewhere.
A real 2026 change worth knowing about
MyCare Ohio — the state's managed care program for people dually eligible for both Medicare and Medicaid — was previously limited to 29 counties. As of January 1, 2026, it began transitioning to Next Generation MyCare, and is expected to be available statewide by August 1, 2026.
This isn't just an expansion — it changes which program you're allowed to use. If you're dually eligible for Medicare and Medicaid and your county is covered by MyCare Ohio, you cannot use the more commonly known PASSPORT waiver instead — you're required to enroll in MyCare Ohio. As coverage expands statewide, this rule will apply to more people than it did even a year ago.
The three main paths for seniors
PASSPORT
Assisted Living Waiver
MyCare Ohio
Who it's for
65+ (or 60-64 disabled), NOT dually eligible
21+ needing residential/assisted living care services
Dually eligible (Medicare + Medicaid) in covered counties
Setting
Your own home
Assisted living residence (room/board not covered)
Integrated medical + long-term care
Services
Adult day care, home care, home modifications, medical equipment
Personal care services only — not room and board
Full coordinated medical and LTSS benefits
Source: Ohio Department of Medicaid (ODM); figures effective 2026. Note: not all assisted living residences accept Assisted Living Waiver participants — confirm before assuming a facility qualifies.
The 2026 financial numbers
1
Income limit: $2,982/month (300% of the federal benefit rate) — over this requires a Qualified Income Trust (Miller Trust).
2
Asset limit: $2,000 single, $3,000 couple — the standard federal figures. Home equity is exempt up to $752,000 if you live there or intend to return.
3
Spousal protection: the community spouse can keep 50% of assets, between $32,532 and $162,660, plus a Monthly Maintenance Needs Allowance between $2,643.75 and $4,066.50 depending on their own income and housing costs.
How to actually start
1
Confirm whether you're dually eligible for Medicare and Medicaid, and whether your county is currently in the MyCare Ohio coverage area — this determines which program you're actually able to use, not personal preference.
2
If pursuing the Assisted Living Waiver, confirm with the specific facility that they accept waiver participants before assuming — not all do, and room and board isn't covered regardless.
What is the difference between PASSPORT and MyCare Ohio?
PASSPORT serves non-dually-eligible seniors; MyCare Ohio is mandatory for dual-eligible individuals in covered counties, and the two aren't interchangeable.
Is MyCare Ohio available everywhere in the state?
Not yet, but it's expanding to statewide coverage by August 1, 2026 as part of the Next Generation MyCare transition.
What's Ohio's Medicaid asset limit for long-term care?
$2,000 single, $3,000 married couple — the standard federal figures.