Medicaid is a healthcare safety net for low-income Ohioans, and each state sets its own eligibility rules. In Ohio, enrollment is substantial; according to the Health Policy Institute of Ohio, roughly one in four residents was covered in 2025. For 2026, the core dollar limits nudge up by about 3% overall, according to the Ohio Department of Medicaid, the Special Income Level rises from $2,901 to $2,982 (about 2.8%), the community spouse resource allowance range increases from $31,584–$157,920 to $32,532–$162,660 (about 3%), and the MMMNA cap moves from $3,948 to $4,066.50 (about 3%). We’ll break down what these changes mean and how to qualify under the new rules.
We know Medicaid eligibility and asset planning can feel overwhelming, and that’s why Jarvis Law Office is here to make the process easier for Ohio families. Our one-time flat fee keeps planning affordable, and we work with your financial advisor so everything stays aligned with your goals. Clients often share that they value our clear guidance and the peace of mind that comes from having a team they can trust.
Key Takeaways
- Ohio Medicaid income and asset limits increased by roughly 3% from 2025, according to updated state eligibility standards.
- Spousal protections such as the CSRA and MMMNA also rose for 2026, helping the community spouse retain more resources.
- Accurate documentation is essential, as ongoing eligibility reviews continue to cause delays and coverage interruptions statewide.
What Is Medicaid?
Medicaid is a joint federal and state program that offers health coverage to eligible low-income individuals. It helps pay for doctor visits, hospital stays, prescriptions, preventive care, and for seniors, it can also cover expensive long-term care in nursing homes or at home.
For Ohio seniors who need long-term care, the financial limits move each year. According to Medicaid Planning Assistance, the 2026 income cap for a single long-term care Medicaid applicant in Ohio is $2,982 per month, up from $2,901 per month in 2025. That is an increase of 81$, or about 2.8% year over year.
Who Does Medicaid Target in Ohio in 2026?
According to the Ohio Department of Medicaid, Medicaid serves several main groups, each with its own rules and financial limits:
- Adults under 65 with low income
- Pregnant individuals
- Children and teens under 19
- Seniors 65 and older
- People who are blind or disabled
Each group has different income and sometimes asset limits. Seniors and people who need long-term care have some of the strictest rules, which is why those 2025 to 2026 changes matter so much.
Income Limits by Group in Ohio (2026)
Eligibility for Medicaid in Ohio is tied to household income expressed as a percentage of the Federal Poverty Level (FPL).
The percentages below remain the same each year, but the actual dollar amounts increase annually when the FPL increases.
According to federal poverty guidelines, the 2026 FPL increased by about 3.3% compared to 2025, which means the income dollar amounts for most groups rise at roughly the same rate.
Adults Under 65
- Income limit: 138% of FPL
- This is the standard ACA expansion category for working-age adults without Medicare.
2026 change
Because the underlying FPL rose by about 3.3%, the actual dollar income limit for this category increased by approximately 3.3% as well, even though the 138% level remains constant.
Pregnant Women
- Income limit: 205% of FPL
- Coverage includes pregnancy and the extended one-year postpartum period.
2026 change
The dollar amount associated with 205% of FPL increased by about 3.3%, matching the FPL increase for 2026.
Children
- Income limit: 211% of FPL
- Covers children under age 19, supporting preventive and ongoing healthcare needs.
2026 change
The dollar income threshold for children also increases by about 3.3% due to the higher 2026 FPL.
Seniors & Disabled Individuals
- Income limit: Based on Supplemental Security Income (SSI) standards rather than FPL.
- According to federal figures, the SSI individual rate increased from $943 in 2025 to $994 in 2026, which is a 5.4% increase.
- This SSI increase affects Medicaid eligibility for aged, blind, and disabled individuals because Ohio uses SSI-related financial criteria for this group.
- Seniors needing long-term care follow different income caps (see comparison below).
How 2026 Senior & Long-Term Care Income Limits Compare to 2025
Ohio’s long-term care Medicaid program uses a Special Income Level rather than FPL or SSI.
Single Applicant Income Cap
- 2025: $2,901 per month
- 2026: $2,982 per month
- Increase: +$81
- Percentage change: +2.8%
Married Couple — Both Applying
- 2026: $5,964 per month combined
(This is simply 2 × the 2026 single cap, according to Medicaid Planning Assistance.)
These changes matter, particularly for seniors close to the income limit: the roughly 2.8% increase in 2026 may allow applicants who were slightly over the cap in 2025 to qualify without needing as much income restructuring or a Qualified Income Trust.
Updated Asset Limits for Special Groups (2026)
Asset rules matter most for seniors and applicants needing long-term care. Ohio’s long-term care Medicaid programs continue to use strict asset thresholds, but several spousal protections increased for 2026.
1. Nursing Home Medicaid (2026 Asset Limits)
For a single applicant in 2026:
- Countable asset limit: $2,000 (same as 2025)
- Special Income Level:
- 2025: $2,901
- 2026: $2,982
- Change: +$81 (+2.8%)
For a married couple (one spouse applying):
- Applicant asset limit: $2,000
- Non-applicant spouse may retain up to the CSRA maximum
(see below for exact 2025 → 2026 changes)
2. SSI Recipients (2026)
- SSI recipients automatically qualify for Medicaid
- Asset limits remain:
- $2,000 for individuals
- $3,000 for couples
- According to federal SSI standards, the SSI monthly benefit increased 5.4% from 2025 to 2026, but asset limits did not change.
Spousal Impoverishment Protections (2026)
Ohio updates spousal allowances every January based on federal formulas. These increases help ensure the spouse remaining at home can maintain financial stability.
Community Spouse Resource Allowance (CSRA)
According to the updated 2026 Medicaid standards:
CSRA Minimum
- 2025: $31,584
- 2026: $32,532
- Increase: +$948 (+3.0%)
CSRA Maximum
- 2025: $157,920
- 2026: $162,660
- Increase: +$4,740 (+3.0%)
This means the community spouse may keep up to $162,660 of the couple’s countable assets in 2026.
Minimum Monthly Maintenance Needs Allowance (MMMNA)
This protects income for the spouse who remains at home.
MMMNA Maximum
- 2025: $3,948
- 2026: $4,066.50
- Increase: +$118.50 (+3.0%)
MMMNA Minimum
- Federal updates typically raise the minimum by ~3%, though Ohio aligns with federal CMS guidance each July.
These increases can significantly improve eligibility planning for married applicants.
Penalty Divisor Changes (2026)
Ohio uses a penalty divisor to calculate the number of months an applicant must self-pay long-term care costs if assets were gifted during the 5-year look-back period.
- 2025 Penalty Divisor: $7,453
- 2026 Penalty Divisor: $7,734
- Increase: +$281 (+3.8%)
Why This Matters
A higher penalty divisor means each dollar gifted results in a slightly shorter penalty period in 2026 compared to 2025.
Impact of Recent Legislation on Ohio Medicaid (Updated for 2026)
According to the Ohio Department of Medicaid:
- The end of continuous coverage caused over 867,000 disenrollments during redetermination.
- Redetermination continues into 2026, making timely documentation essential.
- Federal funding still makes up approximately 73% of Medicaid’s budget, reinforcing its central role in Ohio’s healthcare system.
Changes Affecting 2025 → 2026
- Eligibility limits increased by 2.8–3% across most programs
- Spousal protections increased by roughly 3%
- Penalty divisor increased 3.8%, reducing penalty length for asset transfers
- SSI benefit increase of 5.4% affects ABD Medicaid applicants
These updates widens eligibility slightly, especially for seniors with borderline income or married couples with moderate savings.
Medicaid Eligibility Redetermination in Ohio (Updated for 2026)
After pandemic-era protections ended, Ohio resumed full eligibility reviews in April 2023.
According to the Ohio Department of Medicaid:
- Ohio had 14 months to complete its full review
- By spring 2024, more than 867,000 Ohioans were disenrolled
2025 → 2026 Change Context
- Redeterminations remain active, not temporary
- Eligibility will continue to fluctuate throughout 2026 as households submit or fail to submit documentation
- Households should respond within 10 days to all notices to avoid losing coverage
Ready to understand your options?
At Jarvis Law Office, we guide Ohio families through Medicaid planning with clarity and compassion. If you’re looking for a plan that protects your assets and supports your loved ones, visit our contact page and connect with our team.
