It is important to know that Ohio has a 5-year retrospective period of Medicaid. This is a 5-year period during which Medicaid verifies that no assets have been sold or donated below fair market value to meet Medicaid`s asset limit. Unfortunately, some people mistakenly think that the IRS tax exemption extends to Medicaid rules and unknowingly violates the retrospective rule. If it turns out that someone is violating the retrospective period, a non-Medicaid eligibility period follows. The federal government funds a significant portion of the state`s Medicaid programs. States are required to cover certain federally defined stakeholder groups and services. States can also receive federal funding for optional groups and services. The specific parameters of who is covered and what services are covered are defined by a combination of federal and state laws, rules and regulations, and administrative decisions. Before submitting an application, Ohio Medicaid applicants must ensure that they meet all of the eligibility requirements discussed in detail above. For seniors whose income and/or assets are above the limit, Medicaid planning is highly recommended. In addition, the application process can be quite complicated, as documents must be attached to the application. For general information about the Medicaid long-term care application process, click here. To apply for long-term Medicaid care in Ohio, seniors can apply online to Ohio Benefits, call the consumer hotline at 1-800-324-8680, or visit their county office of employment and family services.

People might find their local regional agency on aging office useful, as they should be able to answer questions about the Medicaid program and offer help with applications. The table below provides a brief reference to help seniors determine if they are immediately eligible for long-term care under a Medicaid program. Alternatively, you can take the Medicaid eligibility test. IMPORTANT, not meeting all of the following criteria does not mean that you are not eligible or eligible for a Medicaid program in Ohio. More. 2) Assisted Living Exemption – For individuals who would otherwise require care at the nursing home level, the Assisted Living Exemption provides an alternative. To be clear, this program does not cover the cost of accommodation and meals. Rather, it helps cover the cost of care services in assisted living facilities.

Registration is limited and not all assisted living facilities in the state accept the waiver. For married couples, starting in 2020, the spouse spouse (the non-applicant spouse) of a spouse applying for a Medicaid or Medicaid waiver in a nursing home can keep up to 50% of the couple`s joint assets up to a maximum of $128,640, as shown in the chart above. In other words, if half of the couple`s assets are less than $25,728, the non-applicant spouse can keep 100% of the couple`s joint property up to a maximum of $25,728. This is called the Community Spouse Resource Allowance (CSRA) in Medicaid parlance. As with spousal income assistance, this rule does not extend to regular Medicaid. 2) Medicaid Planning – The majority of people considering Medicaid are „conventions” or „too dignified” or both, but still can`t afford their care costs. For people in this situation, Medicaid planning exists. Working with a Medicaid planning expert, families can employ a variety of strategies to help them become eligible for Medicaid. Learn more or connect with a Medicaid planner. Countable assets include cash, stocks, bonds, investments, credit unions, savings accounts and chequing accounts and real estate in which you do not live. However, for Medicaid eligibility, many assets are considered exempt (uncountable). Exceptions include personal items, household items, a car, irrevocable funeral trusts, and the principal residence, as the Medicaid applicant or spouse lives in the house and the house is valued at less than $595,000 (in 2020).

Nursing home care is a law program in Ohio, but the state`s Medicaid program also offers several programs that help seniors live outside of nursing homes. 1) Institutional/Medicaid Nursing Home – is a claim (anyone eligible receives support) and is provided only in nursing homes. 2) Medicaid/Home and Community Services (HCBS) waivers – Limited number of participants. At home, in adult daycare or assisted living. 3) Regular Medicaid/Aged Blind and Disabled – is a claim (meeting eligibility criteria ensures support is provided) and is available at home or in adult daycares. There are several Medicaid long-term care programs that Ohio seniors may be eligible for. These programs have slightly different eligibility criteria and benefits. To make matters worse, the criteria vary based on marital status, and Ohio offers multiple avenues of eligibility. 1) Qualified Income Trusts (ITQs) – ITQs, also commonly referred to as Miller Trusts, offer people above the Medicaid income limit the opportunity to still be eligible for long-term Medicaid care, as money paid into an ITQ does not count towards the Medicaid income limit. Simply put, you put your income above the Medicaid limit into a trust, and a trustee is appointed to give that person legal control of the money. The account must be irreversible, i.e.

it cannot be changed or terminated once it has been created. In addition, the money in the account can only be used for very specific purposes, such as paying for medical expenses accumulated by the Medicaid participant. For Ohio residents, ages 65 and older, who do not meet the eligibility criteria in the table above, there are other ways to qualify for Medicaid. For Medicaid eligibility, any income received by a Medicaid applicant is counted. To clarify, this income can come from any source. Examples include employment wages, alimony, pension payments, Social Security disability income, Social Security income, IRA withdrawals, and stock dividends. However, if only one spouse of a married couple applies for a Medicaid nursing home or a Medicaid exemption, only the applicant`s income will be counted. In other words, the income of the non-applicant spouse is not taken into account.

For married couples where one spouse applies for regular Medicaid, the combined income of the applicant spouse and the non-applicant spouse counts towards the income limit. (Click here to learn more about how Medicaid counts income for entitlement purposes.) For married couples where only one spouse applies for a Medicaid nursing home or an HCBS Medicaid waiver, there is a minimum monthly child support assistance (MMMNA). This is the minimum monthly income to which the non-applicant spouse is entitled. As of January 2020, that number is $3,216/month. In principle, if the non-applicant has income below this amount, the applicant spouse may transfer some or, in some cases, all of his or her income to bring the non-applicant`s income to that amount. While some states use both a minimum number and a maximum number, the state of Ohio uses a standard number. This rule on impoverishment of the spouse is intended to ensure that the non-applicant spouse has sufficient means of subsistence. To be clear, this rule does not apply to regular Medicaid.