Ohio Medicaid Asset Limit 2026: Countable vs Exempt Assets and Spend Down Rules

When your parent with dementia needs long-term care in Ohio — whether a nursing facility, memory care unit, or home-based PASSPORT waiver — Medicaid eligibility hinges on meeting strict asset limits. Understanding exactly what counts and what doesn't is the difference between qualifying on the first application and triggering a denial that delays care by months.

2026 Asset Limits

Single applicant: $2,000 in countable assets. That's the total your parent can hold on the day they apply for long-term care Medicaid.

Married couple (both applying): $3,000 combined.

These numbers are deceptively simple. The complexity is in how Ohio classifies assets.

What Counts Against the Limit

Countable assets include:

• Cash, checking accounts, savings accounts
• Stocks, bonds, mutual funds, CDs
• Cryptocurrency
• Non-residential real estate (rental properties, vacant land)
• Second vehicles
• Retirement accounts (IRAs, 401ks) that are not in active payout status

That last point catches many families off guard. In Ohio, a parent's IRA or 401k is countable unless they're actively taking Required Minimum Distributions (RMDs). If your parent has a retirement account sitting untouched, it counts dollar-for-dollar against the $2,000 limit.

What's Exempt

Primary residence — Exempt if your parent's spouse, a minor child under 21, or a blind or permanently disabled child of any age lives there. If none of those conditions apply, the home is still exempt as long as your parent's equity interest is at or below $752,000 (2026 limit) and they sign a formal "intent to return" statement.

One vehicle — Exempt at any value if it's used for transport of the applicant or spouse.

Household goods and personal effects — Exempt.

Irrevocable burial trusts — Exempt, plus up to $1,500 in a designated account specifically earmarked for funeral expenses.

Retirement accounts in payout status — If your parent has placed their IRA or 401k into payout mode with RMDs actively being taken, the account itself is exempt (though the monthly distributions count as income for the income-cap test).

Spousal Protections: The Community Spouse Resource Allowance

If only one spouse needs long-term care, Ohio's spousal impoverishment rules protect a significant portion of the couple's assets for the healthy "community spouse."

Here's how it works: on the "snapshot date" (the date of institutionalization or waiver enrollment), the county Department of Job and Family Services calculates the couple's combined countable assets. The community spouse keeps 50% of that total, within these bounds:

• Minimum floor: $32,532 (even if 50% is less, the community spouse keeps at least this much)
• Maximum cap: $162,660 (even if 50% is more, this is the ceiling)

On the income side, the Minimum Monthly Maintenance Needs Allowance ensures the community spouse has at least $2,705 per month (effective July 1, 2026). If their own income is less, a portion of the applying spouse's income transfers to them. If housing costs are especially high, this allowance can increase up to the federal maximum of $4,066.50.

These protections require filing a Spousal Resource Assessment with your county DJFS — they don't apply automatically.

How Spend-Down Works

If your parent's countable assets exceed $2,000, they must spend down to the limit before Medicaid will pay. Legitimate spend-down strategies include:

• Paying off the mortgage on the exempt primary residence
• Making home modifications (wheelchair ramps, bathroom accessibility) to the exempt residence
• Prepaying funeral and burial expenses through an irrevocable trust
• Purchasing a new vehicle (one vehicle of any value is exempt)
• Paying outstanding medical bills and care costs directly
• Establishing a Personal Services Contract to pay a family caregiver at fair-market rates for documented care (this must be signed before services begin — retroactive payments are treated as uncompensated gifts)

What you must not do: gift assets to family members, transfer property below fair market value, or move money into someone else's name. Any uncompensated transfer within the 60-month lookback window triggers a penalty — Medicaid calculates how many months of care they won't pay for by dividing the transfer amount by $7,787 (the 2026 penalty divisor).

The Spend-Down Timeline Trap

Families often assume they can wait to apply until they've spent down. The problem: Medicaid coverage can be retroactive only three months from the application date. If your parent entered a facility six months ago and you haven't applied, those first three months of facility costs are permanently unrecoverable.

Start the application process early, even if you're still spending down. The Ohio Dementia & Memory Care Guide includes an asset classification worksheet and spend-down tracker that maps exactly which assets to convert and in what order, plus a spousal protection calculator with the 2026 CSRA thresholds.

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