Planning for assisted living in Ohio comes with a lot of questions. Will Medicaid cover the costs? What if your income or assets are too high? How can you protect what you’ve worked for while still getting the care you need?
According to 2024 estimates from Senior Living, the average monthly cost of assisted living in Ohio was $5,453. Planning ahead is important to make the most of available benefits and prepare for future expenses.
At Jarvis Law Office, we help Ohio families qualify for Medicaid while protecting their assets through proactive planning. We work alongside your existing financial advisors, so your long-term plans stay on track.
Key Takeaways
- Medicaid in Ohio covers care services in assisted living but does not pay for room and board.
- To qualify for the Assisted Living Waiver, applicants must meet strict income, asset, and medical requirements.
- The application process involves verifying eligibility, submitting financial and medical documents, and selecting a Medicaid-approved facility.
- If Medicaid isn’t an option, alternatives like VA benefits, long-term care insurance, and Ohio senior assistance programs can help cover costs.
What is Assisted Living?
Assisted living provides a residential setting for older adults, offering a home-like environment with both private and shared living spaces. Residents typically have their own room or apartment while enjoying access to communal areas and social activities.
Services often include meals, housekeeping, laundry, and transportation. Additionally, trained staff are available around the clock to assist with personal care needs such as bathing, dressing, toileting, and medication management.
Does Medicaid Cover Assisted Living in Ohio?
Yes, but only for specific care services. Ohio’s Assisted Living Waiver Program helps eligible seniors receive personal care, medication management, and nursing services in an assisted living facility, but it does not pay for room and board.
Medicaid plays a key role in long-term care nationwide. However, according to KFF, Medicaid enrollment is projected to decline by 4.4% in 2025 due to post-pandemic eligibility redeterminations. This shift could impact coverage availability for long-term care services.
Demand for Medicaid-assisted living is growing. According to Medicaid Planning Assistance, as of September 2024, Ohio’s Assisted Living Waiver is approved for approximately 5,967 beneficiaries per year. With limited spots available, many applicants face waitlists.
What Medicaid Covers in Assisted Living
Ohio’s Medicaid program won’t cover rent, food, or utilities at an assisted living facility, but it helps with:
- Personal care assistance (bathing, dressing, grooming)
- Meal preparation and dietary support
- Medication reminders and administration
- Case management and care coordination
- Some skilled nursing services
This means Medicaid helps cover care-related expenses, but residents still need to find a way to pay for housing. Some facilities accept Supplemental Security Income (SSI) benefits or other state aid programs to help cover living costs.
How the Ohio Assisted Living Waiver Works
Here’s how the Assisted Living Waiver Program works:
- It waives the usual Medicaid requirement that long-term care be provided in a nursing home.
- Instead, Medicaid pays for care services in a Medicaid approved assisted living facility.
- Participants must choose from approved facilities that accept the waiver.
Finding Medicaid-Approved Assisted Living Facilities
Not every assisted living facility in Ohio accepts Medicaid waivers. To find a facility:
- Check the Ohio Department of Aging’s database of Medicaid approved providers.
- Contact local Area Agencies on Aging for help locating available spots.
- Ask facilities directly whether they accept the Assisted Living Waiver.
Because waiver spots are limited, waiting lists are common. Families should start the application process early to secure a place.
Medicaid Eligibility for Assisted Living in Ohio
Medicaid doesn’t automatically cover assisted living. Instead, individuals are asked to qualify. Ohio’s Assisted Living Waiver Program has strict income, asset, and medical requirements. If your loved one doesn’t meet all three, they may need to explore alternative financial options.
Income & Asset Limits for 2025
Medicaid has strict financial guidelines. As of 2025, the income limit for a single applicant is $2,901 per month, with an asset cap of $2,000.
Ohio Medicaid Financial Limits
| Status | Monthly Income Limit | Asset Limit |
| Single Applicant | $2,901 | $2,000 |
| Married (Both Applying) | $5,802 | $3,000 |
| Married (One Applying, One Not) | $2,901 (for applicant) | $2,000 for applicant and $157,920 for spouse |
What Counts as Income?
- Social Security benefits
- Pensions
- Retirement withdrawals
- Wages (if still employed)
What Counts as Assets?
- Checking and savings accounts
- Investments and stocks
- Additional properties (not the primary residence)
What Does Not Count Toward Assets?
- The applicant’s primary home (if worth $730,000 or less)
- One vehicle
- Prepaid burial plans
If an applicant’s income exceeds the Medicaid limit, they may still qualify using a Qualified Income Trust (QIT), also called a Miller Trust. This legally redirects excess income into a trust account, making the applicant eligible.
Medical & Functional Requirements
Beyond financial qualifications, applicants must meet Ohio’s nursing home level of care criteria. Medicaid will not approve assisted living benefits unless the person:
- Needs help with daily activities (bathing, dressing, mobility)
- Has cognitive or memory issues requiring supervision
- Requires ongoing medical care (but not 24/7 skilled nursing)
Ohio conducts an assessment to determine whether an applicant meets these standards. The review process involves:
- A medical evaluation by a healthcare professional.
- A functional assessment measuring how much assistance is needed.
- A review of current living conditions to confirm Medicaid-covered services are necessary.
If an applicant doesn’t meet these medical criteria, Medicaid will not cover assisted living care—even if they qualify financially.
How to Apply for Medicaid in 2025
Applying for Medicaid and attaining the Assisted Living Waiver can take weeks or even months, so starting early is vital. Here’s a step-by-step breakdown of the process:
Step 1: Check Medicaid Eligibility
Use Our Ohio Medicaid eligibility guide or consult an Area Agency on Aging to confirm financial and medical qualifications.
Step 2: Gather Required Documents
Applicants need:
- Proof of income (Social Security, pensions, retirement statements)
- Bank statements and asset records
- Medical history and physician assessments
- A Medicaid application form
Step 3: Submit a Medicaid Application
- Applications can be submitted online through Ohio Benefits.
- Paper applications are available through county Medicaid offices.
Step 4: Complete a Level of Care Assessment
- The Ohio Department of Aging or a case manager will conduct an in-person functional assessment.
- If approved, the applicant is placed in the waiver program queue.
Step 5: Choose a Medicaid Approved Assisted Living Facility
- Applicants must select a facility that accepts the waiver.
- Families may face waitlists, so having backup options is essential.
What Happens After Approval?
Once approved, Medicaid covers care services in the chosen facility. However, room and board costs must still be covered separately (through personal funds, SSI, or other assistance programs).
What If You’re Denied?
If Medicaid denies an application due to income, assets, or medical criteria, there are still options:
- Appeal the decision if financial or medical evaluations were incorrect.
- Spend down excess income/assets by covering medical expenses until within limits.
What If You Don’t Qualify? Alternative Financial Assistance Options
If Medicaid denies coverage, other options can help pay for assisted living:
Medicaid Spend-Down & Miller Trust (For those slightly over the income limit)
- Use excess income on medical bills or care expenses to meet Medicaid limits.
- Set up a Qualified Income Trust (Miller Trust) to legally redirect excess income for Medicaid eligibility.
VA Benefits (For Veterans & Spouses)
- Aid & Attendance (A&A) Pension helps cover assisted living costs.
- Veterans Directed Care Program provides funding for personal care.
Long-Term Care Insurance
- Some policies cover assisted living rent, personal care, and medical services.
- Check policy details to confirm benefits.
Ohio Senior Assistance Programs
- PASSPORT Program – Covers in-home care for those not in assisted living.
- Residential State Supplement (RSS) – Helps low-income seniors afford assisted living.
Private Pay & Family Assistance
- Bridge loans provide short-term funding while waiting for Medicaid.
- Reverse mortgages or annuities can convert assets into care funding.
Protect Your Assets & Secure the Care You Need
Medicaid can be a great option for covering assisted living care, but qualifying while protecting your assets takes careful planning. Jarvis Law Office helps Ohio families secure Medicaid eligibility, avoid probate, and manage assets without unnecessary financial loss.
If you’re ready to take the next step, schedule a consultation today. Let’s make sure you or your loved one get the care you need without sacrificing what you’ve worked for!
