Paying for a nursing home with Ohio Medicaid in 2026

What are Ohio's 2026 Medicaid limits for nursing home care?

A single applicant may have countable assets of no more than $2,000, and income above $2,982 a month (300% of the SSI rate) must be placed in a Qualified Income Trust; nearly all remaining income then goes toward the cost of care.

Sources: Ohio Medicaid MEPL No. 191 (January 1, 2026 figures), MEPL No. 195, OAC 5160:1-6-04, 5160:1-6-06 and 5160:1-6-07.

Countable assets exclude the home (up to the equity limit, and fully while a spouse lives there), one car, personal belongings and an irrevocable prepaid funeral. Retirement accounts generally count. The application goes to the county Job and Family Services office or benefits.ohio.gov.

What is a Qualified Income Trust and who needs one?

A Qualified Income Trust, sometimes called a Miller trust, is a special account into which an applicant whose income exceeds $2,982 a month deposits the excess each month, so that Ohio Medicaid can disregard it for eligibility.

The trust money is then paid toward the cost of care, and whatever remains at death goes to the state up to what Medicaid paid. Setting one up correctly matters; county caseworkers can explain the form, and an elder law attorney can draft it. Many Dayton retirees with pensions from the region's former manufacturers or federal service at Wright-Patterson need one.

What does the spouse at home keep?

In 2026 the community spouse may keep countable assets between $32,532 and $162,660 (generally half the couple's countable assets within that range), plus enough of the institutionalized spouse's income to reach a monthly allowance capped at $4,066.50.

The home, one car and the spouse's own income are protected as well. Ohio's figures change each January and July, so check the current Medicaid letters before planning. Couples with assets above the maximum should see an elder law attorney before applying, because some spending on the couple's needs is allowed and some is not.

How does Ohio's five-year look-back work?

Ohio reviews asset transfers made in the 60 months before the application; gifts or sales below fair value create a penalty period, calculated by dividing the amount transferred by Ohio's average private pay rate of $8,669 a month (from September 1, 2026).

Transfers to a spouse are not penalized. Paying a family caregiver can be legitimate, but only with a written care agreement made before the care is given and reasonable pay. Undocumented “thank you” payments to children are one of the most common causes of penalties.

Will Ohio Medicaid take the house after a parent dies?

It may try to recover what it paid from the estate: Ohio's Medicaid Estate Recovery Program seeks repayment of nursing home and waiver costs for recipients 55 and older, and Ohio uses expanded recovery that can reach assets passing outside probate.

Recovery is postponed while a surviving spouse, a minor child or a blind or disabled child lives in the home, and hardship waivers exist. The rules are technical; an elder law attorney can review the family's situation before any deed or account is changed.