Ohio PASSPORT Waiver: The Complete 2026 Guide for Families

PASSPORT stands for Pre-Admission Screening System Providing Options and Resources Today. Despite the awkward acronym, it is the most important Medicaid program for older Ohioans who need in-home personal care but do not want to enter a nursing facility. If your parent is 60 or older, medically complex enough to qualify for nursing home care, and financially eligible for Medicaid, PASSPORT is likely the program that will fund their home care.

This guide covers how PASSPORT works, what it covers, who qualifies in 2026, and what the application process looks like on the ground.

What PASSPORT Covers

The PASSPORT waiver is funded jointly by Ohio and the federal government under Medicaid's Home and Community-Based Services (HCBS) authority. It covers services delivered in the participant's home or community setting — not in an institution.

Services available under the 2026 PASSPORT program include:

• Personal care: Help with bathing, dressing, grooming, toileting, and transferring
• Homemaker services: Meal preparation, laundry, and light housekeeping
• Home-delivered meals: Five days per week for homebound participants; an alternative restaurant voucher option ("Alternative Meals") is available in some regions
• Emergency response systems: Personal medical alert devices
• Non-emergency medical transportation: Rides to doctor appointments, therapy, and pharmacies
• Home modifications (Environmental Accessibility Adaptations): Following the July 2026 waiver amendments, the cap for home modifications increased to $15,000. This covers grab bar installation, wheelchair ramps, widened doorways, roll-in showers, and other adaptations.
• Adult Day Services (ADS): Structured daytime programs at community centers, which stretch the care budget because group rates are lower than one-on-one home care
• Respite care: Short-term relief for unpaid family caregivers
• Structured Family Caregiving: A daily stipend paid to a live-in family caregiver (including spouses, since October 2024) through an agency provider
• Skilled nursing visits: Clinical oversight for medically complex participants
• Consumer-directed care: Options that allow the participant to hire and manage their own personal care worker, including family members who do not live in the home

The program is designed to supplement, not replace, unpaid family caregiving. The total monthly cost of the care plan is subject to a cost-neutrality cap of $14,700 (under OAC 5160-31-03) — the state will not fund home care costs exceeding 60% of what equivalent nursing facility care would cost. This means PASSPORT cannot fund 24-hour professional home care for most participants.

Who Qualifies for PASSPORT

PASSPORT has three distinct eligibility requirements: age, clinical level of care, and financial.

Age

The applicant must be at least 60 years old at the time of application. There is no upper age limit.

Adults under 60 who need nursing-facility-level care in the home use the Ohio Home Care Waiver (OHC), a separate program with similar services but different administrative rules.

Clinical: Nursing Facility Level of Care

To qualify clinically, the applicant must need a Nursing Facility Level of Care (NF LOC). This means their condition — due to physical disability, frailty, cognitive impairment, or chronic illness — is severe enough that, without in-home supports, they would require placement in a skilled nursing facility.

The NF LOC is assessed through the Adult Comprehensive Assessment Tool (ACAT), conducted in-person at the applicant's home by a nurse evaluator from the regional Area Agency on Aging. The evaluator documents:

• Ability to perform Activities of Daily Living (ADLs): bathing, dressing, eating, transferring, mobility, toileting
• Cognitive status and safety judgment
• Behavioral considerations
• Current medications and diagnoses
• Available informal support (family caregiving hours)

To meet NF LOC, the applicant generally needs to require hands-on assistance or supervision with at least two ADLs. Participants should not minimize their limitations during this assessment — the care plan is built on what the evaluator documents.

Financial: Income and Asset Limits

Ohio applies strict Medicaid financial thresholds for PASSPORT. In 2026:

• Income limit: $2,982 per month gross income (the Special Income Level, equal to 300% of SSI). Only the applicant's income counts; a community spouse's income is excluded.
• Asset limit: $2,000 countable assets (single applicant)

If the applicant's gross income exceeds $2,982 per month, a Qualified Income Trust (Miller Trust) is required to establish eligibility. Without it, the application is automatically denied regardless of clinical eligibility.

Exempt assets — the primary home (up to $752,000 equity), one vehicle, household goods, irrevocable burial contracts — do not count toward the $2,000 limit.

If assets exceed $2,000, a compliant spend-down is required before the application can be approved. This means converting countable assets into exempt ones through legitimate purchases — prepaid burial contracts, debt payoff, home modifications — not gifting to family members, which triggers a transfer penalty.

The Application Process: Step by Step

Step 1: Initial contact Call the OBLTSS intake line at 1-844-644-6582 or the Area Agency on Aging statewide referral number at 1-866-243-5678. Provide basic information about the applicant's functional limitations, current diagnoses, and a rough financial picture.

Step 2: Check MyCare Ohio status Ask the intake specialist whether the applicant's county is currently an active Next Generation MyCare Ohio county. If yes, and the applicant is dual eligible (Medicare and Medicaid), they will be directed to the MyCare Ohio managed care pathway rather than the traditional PASSPORT intake. The services are equivalent, but the administrative path is different.

Step 3: ACAT assessment A nurse evaluator schedules an in-home visit. Be prepared: have a list of all current medications, the names of all current doctors, and a clear picture of what the applicant cannot do independently. This assessment determines whether the applicant meets NF LOC.

Step 4: Financial documentation While the clinical assessment is pending, compile 60 months of financial records: bank statements, investment account statements, property deeds, vehicle titles, pension award letters, Social Security benefit letters, and life insurance policies. This is what the county JFS will review.

Step 5: File the Medicaid application Submit Form ODM 07216 (Application for Health Coverage) and the Long-Term Care Supplement (Form ODM 07408) to the county Department of Job and Family Services. If a QIT is required, also submit Form ODM 10193. Applications can be filed in person at the county JFS office or online through benefits.ohio.gov.

Step 6: Notice of Action and provider selection Once the county approves the application, it issues a Notice of Action (NOA) specifying the approved level of care and calculating any patient liability. The AAA case manager then works with the family to select ODH-licensed home care agencies and finalize the individual care plan. The physician must sign the plan before services begin.

What PASSPORT Costs the Family

Approved PASSPORT participants are not exempt from all costs. Most pay patient liability — a calculated share of the cost of care.

For PASSPORT participants, the monthly patient liability is calculated by:

1. Starting with gross monthly income
2. Subtracting the Special Individual Maintenance Needs Allowance (SIMNA) of $1,938.30 (65% of the $2,982 SIL)
3. Subtracting community spouse allowances (if applicable)
4. Subtracting health insurance premiums (Medicare Part B, supplemental insurance)
5. Subtracting any QIT trustee fees (up to $15/month)

The remaining balance is the patient liability, paid directly to the home care providers each month.

If a participant's only income is Social Security of $1,500/month and they have no community spouse, the SIMNA of $1,938.30 exceeds the income, so there is no patient liability. Higher-income participants may pay several hundred dollars per month.

For a complete walkthrough of the PASSPORT application, the clinical assessment, the QIT setup, and the patient liability calculation — plus checklists and templates for every step — the Ohio Aging in Place Guide covers everything a family needs to go from first crisis call to approved care plan.

See more Ohio guides →