Written & Reviewed by
Ohio home-care payment guide
Last updated: 13 September 2026
Ohio has several ways to help pay for care at home. The right route depends on the type of care, current coverage, finances, and whether the person is returning home from a facility. For many older Ohioans, the fastest start is the local aging network or Ohio Benefits Long-Term Services and Supports.
Bottom Line
For ongoing help with bathing, dressing, meals, or transfers, Medicaid is usually the main public payer. PASSPORT serves eligible Ohioans age 60 and older. People with full Medicaid plus Medicare may receive long-term services through Next Generation MyCare. Medicare usually covers qualifying skilled home health, not long-term custodial care. VA, PACE, insurance, and local programs may also help.
Need Help Right Now?
If an older person is unsafe at home, has no caregiver for essential needs, or is being discharged without a safe care plan, do not wait for a routine benefits review. Call 911 for an immediate medical or safety emergency. For urgent Ohio long-term-care navigation, call Ohio Benefits Long-Term Services and Supports at 1-844-644-6582. You can also use our Ohio emergency help guide for food, housing, utility, abuse-reporting, and crisis routes.
Start Here
- Call the aging network. Ohio lists 1-866-243-5678 to connect with a local Area Agency on Aging. Ask for a long-term-care assessment and which home-care program fits the person’s county and coverage.
- Call the statewide LTSS line. Ohio Benefits Long-Term Services and Supports is 1-844-644-6582. It can connect people to long-term services, waiver requests, and local options.
- Name the coverage you already have. Tell the worker whether the person has Medicare, full Medicaid, a MyCare plan, VA health care, or long-term-care insurance. That one detail can change the correct route.
The Ohio aging resource hub confirms the statewide aging and local-agency contacts. Ohio’s LTSS contact page also offers a local office finder and callback request.
Quick Reference: Which Payer Should You Check First?
| Situation | First route | What it may cover |
|---|---|---|
| Age 60+ with ongoing daily-care needs and limited finances | PASSPORT / Ohio Medicaid | Personal care, homemaker help, meals, respite, equipment, modifications, and other approved waiver services |
| Has full Medicaid plus Medicare Parts A, B, and D | Next Generation MyCare | Coordinated Medicare and Medicaid benefits, including qualifying long-term waiver services |
| Homebound and needs skilled nursing or therapy | Medicare home health | Part-time skilled nursing, therapy, and limited aide care when Medicare rules are met |
| Older veteran enrolled in VA health care | VA care team | Homemaker/home health aide, respite, and other home-based services when clinically eligible and available |
| Age 55+ in a PACE service area and needs nursing-facility-level care | PACE | Integrated medical care and long-term services under one care program |
| In an Ohio long-term-care facility for at least 60 days and wants to return home | HOME Choice | Transition planning and supports for a safe move back to the community |
These programs do not all pay for the same kind of care. An assessment, coverage status, financial rules, and provider availability can change what is approved.
First, Know What “Home Care” Means
Personal home care helps with daily tasks such as bathing, dressing, toileting, transfers, meals, and light household work. Home health care is medical or therapy care ordered for an illness or condition. Medicare may pay for qualifying home health, while long-term personal care is more often paid through Medicaid waivers or other long-term-care sources.
If the home itself is unsafe for a walker or wheelchair, payment for care may not solve the whole problem. Ohio readers can also check Ohio home repair help and Ohio equipment resources.
Ohio Medicaid: PASSPORT Is a Main Long-Term Home-Care Route
PASSPORT for adults age 60 and older
PASSPORT is Ohio’s Medicaid home- and community-based services waiver for many older adults who would otherwise need nursing-facility care. The current PASSPORT eligibility rule requires a person to be 60 or older at enrollment, eligible for Medicaid, and assessed at an intermediate or skilled nursing-facility level of care. The person’s needs must also be safely met in a home or community setting.
The 2026 PASSPORT services rule includes personal care, homemaker services, home care attendant services, home-delivered meals, adult day services, respite, emergency response systems, home modifications, medical equipment and supplies, transportation, structured family caregiving, and other approved supports. The care plan decides which services are actually authorized.
Where to start: call the local Area Agency on Aging or Ohio Benefits Long-Term Services and Supports. Our Ohio aging agencies guide explains Ohio’s regional aging network and what to ask.
2026 Medicaid income and resource rules
Long-term-care Medicaid has special financial rules. Ohio’s special income rule sets the special income level at 300% of the current individual Supplemental Security Income rate. Social Security lists the 2026 SSI rate at $994 per month, so the 2026 special income level is $2,982 per month.
The $2,982 figure is a screening point, not a promise of eligibility. If countable income is higher, Ohio’s qualified income trust rule allows a QIT in qualifying long-term-care cases. Ohio’s base Medicaid resource rule lists $2,000 for an individual and $3,000 for a married couple after exclusions. Spouse protections and other long-term-care rules can change how assets are treated. Do not give away property simply to meet a limit.
| Rule | 2026 starting point | Why you should still ask |
|---|---|---|
| Special income level | $2,982/month | Countable income rules apply, and a QIT may help when income is above the level. |
| Base individual resource limit | $2,000 after exclusions | Some assets are excluded, and long-term-care rules may treat a home, spouse, or transfers differently. |
| Base married-couple resource limit | $3,000 after exclusions | Spousal-impoverishment protections can change what a community spouse may keep. |
| Patient liability | Case-specific | Some waiver recipients may have to contribute part of income toward care. |
How to request a waiver
Call 1-844-644-6582 and ask for an assessment for home and community-based long-term services. Ohio’s HCBS waiver request form also explains how to request a waiver.
PASSPORT requires an available slot. Ohio’s PASSPORT Home First route can give certain eligible people priority, including some people in nursing facilities or facing a hospital-to-nursing-facility discharge. Ask whether Home First applies before discharge plans are final.
Ohio also has a limited state-funded PASSPORT component. It is not a general substitute for Medicaid. Current law mainly covers certain legacy participants and some people whose Medicaid-funded PASSPORT application is still pending after nonfinancial eligibility is established. Ask the aging agency whether this temporary bridge applies while financial eligibility is being decided.
Next Generation MyCare Is Now Statewide
Next Generation MyCare is a major 2026 change. Ohio expanded the program in phases and made it available in all Ohio counties on August 1, 2026.
The current Next Generation MyCare page says enrollment applies to people who have full Medicaid, Medicare Parts A, B, and D, and are age 21 or older, subject to listed exclusions. The MyCare eligibility rule confirms the core Medicare and Medicaid requirements.
If an older adult has full Medicaid plus Medicare, ask which MyCare plan is assigned and who the waiver or care coordinator is. The Ohio Medicaid Consumer Hotline is 1-800-324-8680.
If a relative is already doing much of the care, also see our Ohio family caregiver guide. Some Medicaid service models can pay approved relatives, but the service plan, provider rules, and relationship rules matter.
What Medicare Pays for at Home
Medicare is useful when the need is medical and intermittent. It is not a general long-term-care program. Under current Medicare home health rules, a person may qualify when a provider certifies the need for part-time or intermittent skilled services and the person is homebound. A Medicare-certified home health agency must provide the care.
Covered services can include skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social services, and part-time home health aide care. The aide benefit is available only when the person is also receiving qualifying skilled services. Medicare says the patient pays $0 for covered home health services, although other costs can apply, such as the normal Part B cost-sharing rules for durable medical equipment.
Reality check: Medicare does not turn into ongoing custodial home care just because a person needs help every day. If the main need is months or years of bathing, dressing, meal help, supervision, or companionship without a skilled-care need, check Medicaid, VA benefits, PACE, insurance, or private-pay options.
If Medicare premiums and cost sharing are squeezing the home-care budget, our Ohio Medicare Savings guide explains programs that may reduce other health costs. Saving on premiums is not the same as paying a caregiver, but it can free money for household needs.
Veterans May Have Separate Home-Care Paths
Eligible veterans should ask the VA before paying privately. VA’s current Homemaker and Home Health Aide program can provide help with daily activities through contracted organizations. VA says enrolled veterans may receive the service when they meet clinical and community-care criteria and the service is available locally. A copay can apply depending on service-connected disability status.
Some veterans or surviving spouses who already qualify for VA pension may also qualify for extra Aid and Attendance benefits when they need help with daily activities or meet another qualifying condition. That is a pension add-on, not an automatic home-care benefit for every veteran.
Start with the veteran’s VA care team or social worker and ask for a home- and community-based services assessment. Our Ohio veteran benefits guide also explains Ohio and county veteran-service contacts.
PACE and HOME Choice Can Fit Special Situations
PACE
Ohio’s Program of All-Inclusive Care for the Elderly, or PACE, combines medical care and long-term services through one program. The current PACE eligibility rule requires a person to be at least 55, live in a PACE organization’s service area, meet an intermediate or skilled level of care, and be able to live safely in the community. PACE has a limited service area, so confirm current ZIP-code coverage before making plans.
Medicaid-eligible participants must maintain Medicaid eligibility and may have patient liability. A person can also enroll without Medicaid if eligible for PACE and able to pay the required premiums. PACE generally replaces other Medicaid managed-care or waiver enrollment rather than being added on top.
HOME Choice
If the person is already in a facility and wants to return home, Ohio’s HOME Choice program can help with the transition. Current eligibility includes Medicaid enrollment, age 18 or older, residence in an Ohio long-term-care facility for at least 60 consecutive days, a source of support for community living, and care needs that can safely be met in the community.
HOME Choice is not simply a monthly caregiver check. It is a transition program that helps build a safe move back to the community and connect services. Ask the facility social worker or transition staff about it before discharge plans are final.
Private Pay, Long-Term-Care Insurance, and Combining Help
Private pay may fill a gap while public help is pending or when a household is not eligible. Before signing an agency contract, ask for the hourly rate, minimum shift, weekend rate, mileage, cancellation fees, and whether the same caregiver is likely to return.
If long-term-care insurance already exists, ask the insurer about the benefit trigger, elimination period, payment maximums, approved-provider rules, and whether family care can qualify. Families can also combine sources: Medicaid for approved personal care, local programs for meals or respite, Medicare for a skilled episode, and private funds for uncovered hours.
For other disability routes, see our Ohio disability help guide. If housing costs are crowding out care, check our Ohio housing help guide.
What to Gather Before You Call
- Photo ID and Social Security number.
- Medicare, Medicaid, MyCare, VA, and insurance cards.
- Proof of monthly income.
- Recent bank, investment, and property records.
- Medication list and doctor names.
- A list of daily tasks the person cannot safely do alone.
- Facility discharge papers, if relevant.
- Power-of-attorney or representative papers, if relevant.
- Long-term-care insurance policy pages, if any.
Do not wait until every document is perfect before making the first call. Start the screening, then ask exactly which proofs are still needed.
How to Start Without Wasting Time
- Describe the care need first. Say what help is needed every day and what happens if no one is there.
- State the coverage. Say whether the person has Medicare, Medicaid, both, VA care, or private insurance.
- Name the next step. Ask which program is screening the case, who owns the next action, and what is still needed.
- Keep a record. Save the worker’s name, date, case number, notices, portal messages, and copies of forms.
Reality Checks That Matter in Ohio
A waiver is not instant staffing. Approval does not guarantee that an agency has an aide available for every authorized hour. Ask what happens if a provider cannot staff the plan.
PASSPORT can have slot limits. Ohio rules require an available waiver slot. If a slot is unavailable, ask about the unified waiting list and whether the person may qualify for Home First priority.
Medicaid may involve estate recovery. Ohio law generally requires estate recovery for certain Medicaid costs paid for a person age 55 or older after death, subject to survivor protections and hardship rules. Review the Ohio estate recovery law before making major property decisions. Ohio law also says a Medicaid lien generally may not be imposed before death unless the recipient is permanently institutionalized, with additional protections and exceptions in the Medicaid lien law.
Do not transfer assets casually. Giving away a home, cash, or investments can affect long-term-care Medicaid eligibility. If property, a spouse, a trust, or a large transfer is involved, consider qualified elder-law advice before acting.
Common Mistakes to Avoid
- Assuming Medicare pays indefinitely. Medicare home health is tied to skilled-care and homebound rules, not general around-the-clock custodial care.
- Self-denying over income. Income above $2,982 does not automatically end the inquiry because Ohio permits qualified income trusts in qualifying long-term-care cases.
- Ignoring MyCare. Next Generation MyCare is statewide in 2026 for eligible dual Medicare-Medicaid members.
- Hiring before checking coverage. A public program or insurer may require an approved agency or provider arrangement.
- Calling home care a grant. Most Ohio long-term home care is a Medicaid service benefit, insurance benefit, VA service, or privately purchased service, not a cash grant.
- Missing notices. Open every Medicaid or managed-care letter. Appeal deadlines can run from the notice date.
Denied, Delayed, or Overwhelmed
If Medicaid, PASSPORT, or a MyCare service is denied, ask for the decision in writing and read the appeal instructions immediately. Ohio’s state hearing rule generally gives 90 calendar days to request a hearing after a notice of action. For a MyCare adverse-benefit decision, the member generally must use the plan appeal process first, then may request a state hearing within the applicable 90-day period after the plan’s appeal resolution.
While an appeal is pending, ask the aging agency, plan, or 211 about short-term respite, meals, adult day, transportation, and emergency caregiver support. Keep the home-care plan safe rather than waiting for one program to solve every need.
Backup Options if the Main Route Does Not Work
| Problem | Next step | Useful question |
|---|---|---|
| Medicaid application is pending | Ask the AAA about local respite, meals, adult day, and caregiver support | “What can start before Medicaid is decided?” |
| Waiver approved but no aide is available | Call the case manager or MyCare coordinator | “Can another agency, individual provider, or approved service cover these hours?” |
| Income looks too high | Ask the Medicaid worker about QIT and long-term-care rules | “Please screen this as a long-term-care Medicaid case, not ordinary Medicaid only.” |
| Person is leaving a facility | Ask about HOME Choice and Home First before discharge | “Can a community plan be arranged before a nursing-facility placement?” |
| Care costs are crowding out basic bills | Screen for separate senior benefits | “Which food, housing, medical, or utility benefits could lower other monthly costs?” |
For a broader benefits check, use our Ohio senior benefits guide.
Phone Scripts You Can Use
Ohio LTSS / Area Agency on Aging
“I am calling for an older Ohio resident who needs help with bathing, dressing, meals, and staying safe at home. We want to avoid nursing-home placement. Can you start a long-term-care assessment and tell me whether PASSPORT, MyCare, PACE, or another service fits?”
Next Generation MyCare
“The member has full Medicaid and Medicare Parts A, B, and D. Which MyCare plan is active, who is the care coordinator, and how do we request an assessment for long-term home-care waiver services?”
Doctor or home-health office
“The patient is having trouble leaving home and needs skilled care after this illness or injury. Can you tell us whether they meet Medicare home-health rules and, if so, send an order to a Medicare-certified home health agency?”
VA social worker
“The veteran needs regular help with daily activities at home. Can you screen for Homemaker/Home Health Aide, respite, Veteran-Directed Care, or another VA home- and community-based service available in this area?”
Resumen en Español
En Ohio, Medicaid suele ser la principal opción pública para pagar cuidado personal de largo plazo en el hogar. PASSPORT puede ayudar a personas de 60 años o más que cumplen las reglas de Medicaid y necesitan un nivel de cuidado similar al de un centro de enfermería. Si la persona tiene Medicaid completo y Medicare, pregunte por Next Generation MyCare.
Para empezar, llame a Ohio Benefits Long-Term Services and Supports al 1-844-644-6582 o a la agencia local sobre envejecimiento al 1-866-243-5678. Tenga a mano las tarjetas de Medicare y Medicaid, comprobantes de ingresos y recursos, medicamentos y una lista de las actividades diarias con las que la persona necesita ayuda.
Medicare puede pagar cuidado de salud en el hogar cuando se cumplen sus reglas médicas, pero normalmente no paga cuidado personal de largo plazo por sí solo. Si recibe una negación, pida la decisión por escrito y revise inmediatamente las instrucciones y la fecha límite para apelar.
Frequently Asked Questions
Does Medicare pay for home care in Ohio?
Medicare can pay for qualifying home health when a person is homebound and needs part-time or intermittent skilled services ordered by a provider. It does not usually pay for long-term personal care by itself when the main need is bathing, dressing, meals, supervision, or companionship.
What Ohio program pays for long-term home care for seniors?
PASSPORT is a major Ohio Medicaid home-care waiver for eligible adults age 60 and older who meet Medicaid and nursing-facility-level-of-care rules. Eligible people who have both full Medicaid and Medicare may instead receive waiver services through Next Generation MyCare.
What is the 2026 Medicaid income level for Ohio long-term care?
Ohio’s special income level is 300% of the individual SSI federal benefit rate. The 2026 SSI rate is $994, making the 2026 special income level $2,982 per month. Countable-income rules still apply, and a qualified income trust may help some people whose income is above that level.
Can a family member be paid to provide home care in Ohio?
Sometimes. Ohio Medicaid includes participant-directed and structured family-caregiving services in some care plans. Approval depends on the person’s program, assessed needs, relationship rules, provider requirements, and the specific service authorized.
Is Next Generation MyCare available everywhere in Ohio?
Yes. Ohio completed the 2026 phased rollout on August 1, 2026, making Next Generation MyCare available in all Ohio counties for people who meet the program’s eligibility rules.
What should I do if PASSPORT or Medicaid home care is denied?
Ask for the decision in writing, read the hearing or plan-appeal instructions, and act before the deadline. Ohio generally allows 90 calendar days to request a state hearing after a notice of action, while MyCare cases may require the plan appeal process before a state hearing.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Last verified: 13 September 2026. Next review: 13 December 2026.
Corrections
Despite careful verification, errors may occur. Readers may email info@grantsforseniors.org with corrections.
Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 13 September 2026 · Next review: 13 December 2026
About the Authors