Ohio Home Care Waiver: Who Qualifies and What It Covers

Ohio runs several Medicaid waiver programs that pay for in-home care rather than nursing facility placement. Two of the most important for families are the PASSPORT Waiver (for adults 60 and older) and the Ohio Home Care Waiver (for adults under 60 with physical disabilities or chronic health conditions). These are distinct programs with different rules — but the goal of both is the same: allow people to stay safely at home instead of entering a nursing facility.

If your parent or family member is under 60, or if you are trying to understand all of Ohio's home care waiver options, this guide covers what each program provides, who qualifies, and how the application process works.

The Ohio Home Care Waiver (For Adults Under 60)

The Ohio Home Care Waiver (OHC) is administered by the Ohio Department of Medicaid under Ohio Administrative Code Chapter 5160-46. It serves adults aged 21 to 59 who have physical disabilities or chronic health conditions that would otherwise require nursing facility care.

This is the program for younger adults who have had a disabling injury, live with a progressive neurological condition, or have chronic illnesses requiring daily assistance. It is not age-restricted at the upper end — a 58-year-old with advanced MS or a 45-year-old recovering from a serious accident may qualify.

Ohio Home Care Waiver Eligibility Requirements

To qualify for the Ohio Home Care Waiver, an individual must meet all of the following:

Age: Between 21 and 59 years old at the time of application.

Ohio residency: Must be an Ohio resident.

Medicaid financial eligibility: The same income and asset rules that apply to all Ohio long-term care Medicaid programs apply here. In 2026, the Special Income Level (SIL) income cap is $2,982/month gross income. Countable assets must be below $2,000 (single applicant). If gross income exceeds the cap, a Qualified Income Trust (Miller Trust) is required.

Level of care: The applicant must meet a nursing facility level of care — meaning their condition is severe enough that, without in-home supports, they would need to be in a nursing home. This is assessed through a clinical evaluation.

Community setting: The waiver only covers care delivered in the applicant's home or community. It does not cover institutional care.

Ohio Home Care Waiver Services

The services covered under the OHC Waiver are designed to fill in the gaps between what Medicare covers (short-term skilled nursing and therapy) and what private-pay or family caregivers can sustain alone. Covered services include:

• Personal care services: Help with bathing, dressing, grooming, toileting, and mobility
• Homemaker services: Light housekeeping, laundry, and meal preparation
• Home-delivered meals: Nutritious meals delivered to the home
• Non-emergency transportation: Rides to medical appointments and community activities
• Emergency response systems: Personal medical alert devices
• Home modifications: Environmental adaptations to support independent living — ramp installation, grab bars, widened doorways
• Skilled nursing visits: Wound care, medication management oversight, and clinical monitoring
• Respite care: Temporary relief for unpaid family caregivers

The waiver has a monthly cost cap. The total value of covered services must remain cost-neutral compared to what Medicaid would spend on nursing facility care for the same person.

The PASSPORT Waiver (For Adults 60 and Older)

The Pre-Admission Screening System Providing Options and Resources Today (PASSPORT) waiver is Ohio's primary home-care program for adults aged 60 and older. It is administered through the 12 regional Area Agencies on Aging and covers a comparable range of services.

PASSPORT is the waiver most families with an aging parent will encounter. Key features:

• Minimum age of 60 at the time of application
• Same financial eligibility thresholds as OHC ($2,982 income cap, $2,000 asset limit)
• Requires a nursing facility level of care assessment using the Adult Comprehensive Assessment Tool (ACAT)
• Services are coordinated by an AAA case manager who develops and monitors the individual care plan
• Individual service plans are subject to a monthly cost-neutrality cap of $14,700 (under OAC 5160-31-03)

PASSPORT also supports consumer-directed care options, including the Choices Home Care Attendant Service (C-HCAS) and Consumer-Directed Personal Care Service (CD-PCS), which allow adult family members to be paid for providing care.

Starting October 2024, PASSPORT added Structured Family Caregiving — a service that allows a live-in family member (including spouses) to be employed through an agency and paid a daily stipend for providing care. This was a significant change because spouses were historically excluded from being paid for care.

How the Application Process Works

For both waiver programs, the process begins with a call to the Ohio Benefits Long-Term Services and Supports (OBLTSS) intake line at 1-844-644-6582, or directly to your regional Area Agency on Aging at 1-866-243-5678.

Before you call, gather:

• The applicant's gross monthly income from all sources (Social Security award letter, pension statements, VA benefit letter)
• A rough picture of total countable assets (bank statements, investment account statements)
• A description of the applicant's functional limitations — what they can and cannot do independently with bathing, dressing, eating, mobility, and other daily activities

After the telephonic screening, the AAA or program staff will schedule a face-to-face clinical assessment in the applicant's home. For PASSPORT, this is the ACAT (Adult Comprehensive Assessment Tool). For OHC, a similar functional evaluation is conducted.

The clinical assessment is the most important step. The evaluator documents what the applicant cannot do independently. Families should resist the urge to have the applicant minimize their limitations during this visit — if the assessor does not see the daily challenges, the care plan will not reflect them.

After clinical approval, the Medicaid financial application (Form ODM 07216) is submitted to the county Department of Job and Family Services. If the applicant's income is above the $2,982 cap, Form ODM 10193 (QIT verification) is submitted at the same time.

The county has 45 days to make an eligibility determination. Once approved, the AAA case manager or program coordinator finalizes the individual service plan and connects the applicant with licensed home care agencies.

MyCare Ohio and Home Care Waivers

One important complication in 2026: Ohio is rolling out the Next Generation MyCare Ohio program statewide throughout the year. This program consolidates Medicare and Medicaid benefits for dual-eligible individuals (those who qualify for both) into a single managed care plan.

For dual-eligible adults in MyCare Ohio counties, the traditional PASSPORT waiver is not available as a standalone program. Instead, in-home personal care and support services are covered through the integrated MyCare Ohio Waiver, managed by one of three plans: Anthem, CareSource, or Molina.

This affects both seniors 60+ and younger adults who are dually eligible. The application process and services are similar, but the administrative pathway runs through the selected managed care plan rather than directly through the AAA.

If your family member is not dually eligible — meaning they have Medicaid only, not Medicare — they remain on the traditional fee-for-service PASSPORT or OHC pathway regardless of which county they live in.

For a complete guide to navigating Ohio's home care waiver system — including the clinical assessment process, how to set up a Qualified Income Trust, how to choose between agency-directed and consumer-directed care, and how MyCare Ohio affects dual-eligible seniors — the Ohio Aging in Place Guide covers the full process with step-by-step checklists and templates.

See more Ohio guides →