Medicaid is the nationwide health coverage program designed to extend basic health services, such as emergency and acute care, primary care and long-term care, to those who have a low income and few resources. In Ohio, a Medicaid-expansion state, three out of five nursing home residents are covered by Medicaid and 74% of seniors meet Medicaid-eligibility requirements. Seniors who are seeking Medicaid coverage must meet income and asset (resource) limits. Individuals can earn up to $2,313 per month and own up to $2,000 in countable assets, while couples applying together can earn up to $4,626 a month and own up to $3,000 in countable assets. Qualified Income Trust Seniors who earn more than the current Medicaid limits may be able to qualify for Medicaid coverage by entering into a legal agreement with the state known as a Qualified Income Trust. Also called a Miller Trust, seniors can deposit their excess income into a QIT in order to lower their declared income to achieve Medicaid eligibility. Upon death, any money in the QIT is payable to the state of Ohio. For more information on the QIT contact Automated Health Systems at (844) 265-4722. Ohio Assisted Living Waiver Seniors who are covered by Medicaid and require help performing one or more activities of daily living, such as bathing, grooming, using the toilet and/or navigating their environment, may qualify for the Ohio Assisted Living waiver. This Medicaid waiver program covers the cost of care for eligible seniors within an assisted living facility to prevent or delay nursing home placement. If approved, seniors may be provided with one or more of the following supports:
- Skilled and intermittent nursing care
- Medication management and administration
- Housekeeping and laundry service
- A wearable emergency response system
- Access to 24-hour assistance within their assisted living facility
- Personal care, including help with eating and/or personal hygiene.
Note: Seniors who are enrolled in the ALW continue to pay for the room-and-board portion of their assisted living costs, and approval for the ALW doesn’t guarantee placement in an ALW-participating facility. For more information and to request an ALW assessment, contact the
Council on Aging of Southwestern Ohio, the Area Agency on Aging at (800) 252-0155.
MyCare Ohio Warren County residents who are eligible for both Medicaid and
Medicare coverage are required to enroll in
MyCare Ohio, a managed care health plan that consolidates delivery of all Medicaid and Medicare benefits. MyCare Ohio is designed to reduce service gaps for seniors by creating a single contact point to access care services. Seniors are provided with a personalized care plan that identifies their unique needs, which may include placement in a long-term care facility and/or enrollment in the Ohio Assisted Living waiver. There are
two health plans available to Warren County residents who are MyCare Ohio members, and these plans are subject to change. For more information on Ohio Medicaid, the ALW or MyCare Ohio, contact Ohio’s
Medicaid Consumer Hotline at (800) 324-8680.