Established by the federal government under President Lyndon B. Johnson in 1965, Medicaid is a nationwide federal-state program that gives low-income children, families and adults of all ages access to basic health coverage. An estimated 74 million Americans rely on Medicaid, including nearly three million in Ohio where one in five residents receive Medicaid benefits. To qualify for free Medicaid coverage in Ohio, seniors may earn no more than the Special Income Level, which is set at three times the current Social Security Federal Payment Standard. As of 2019, the SSI payment increased to $771 a month, resulting in a $2,313 monthly income limit for singles, and $4,626 limit for couples to be eligible for Medicaid. Countable asset limits of $2,000 for an individual and $3,000 for a couple also apply. Applicants can own a home that they live in valued up to $585,000, one vehicle and an irrevocable burial trust without incurring any penalty from Medicaid. MyCare Ohio Residents of Dublin who are enrolled in both Medicaid and Medicare must participate in the MyCare Ohio Plan, since the city of Dublin is located in Franklin, Delaware and Union, three counties where the MCOP is available. The MCOP is designed to simplify health care for eligible seniors by providing a single point of contact for both Medicaid and Medicare benefits. There are currently two Managed Care Organizations providing service through the MCOP under the overall administration of the Ohio Department of Medicaid, and eligible seniors may qualify for non-skilled medical services to help them remain in an assisted living facility rather than be placed in a nursing home. Ohio Assisted Living Medicaid Waiver Program Medicaid-eligible seniors who require daily assistance from another person to perform activities of daily living, such as grooming, toileting, eating or dressing, may qualify for the Ohio Assisted Living Medicaid Waiver Program. This program provides seniors with enhanced personal support services within an assisted living facility that is licensed by the Ohio Department of Health and certified as as Assisted Living Provider by the Ohio Department of Aging. The Ohio ALW program covers the cost of care services that are not normally included with the room and board portion of assisted living fees. Depending on the needs of each senior, enhanced assisted living services may include:
- Housekeeping, including laundry and maintenance
- Provision of three meals daily
- Social and recreational programming
Eligible seniors currently living in a nursing facility who qualify for the ALW may also have access to community transition services to help seniors obtain the necessary furnishings and items in order to reside in an assisted living facility.
Qualified Income Trust Ohio seniors who earn more than the $2,313 a month and require placement in an assisted living facility may need a
Qualified Income Trust (QIT) in order to be eligible for Medicaid. Also known as a Miller Trust, a QIT is a legal agreement that waives the current income eligibility limit for Medicaid institutional and HCBS waiver services when the Medicaid applicant agrees to divert all excess income into a non-revocable trust, naming the state of Ohio as the sole beneficiary. Money in the QIT may be used to pay for incurred medical expenses, trust maintenance fees and a modest maintenance needs allowance for the senior. Upon death, Medicaid receives all funds in the QIT up to the total cost of the care that was provided to the senior through Medicaid. For more information on Ohio Medicaid services and the Assisted Living Medicaid Waiver Program, contact the
Ohio Medicaid Consumer Hotline at (800) 324-8680 or the
Central Ohio Area Agency on Aging at (614) 645-7250.