Medicaid offers a broad range of services for individuals with special health care needs. In some situations, the most appropriate option for a person with a severe disability or medically unstable condition is care in an institutional setting, such as a nursing home or, for individuals with intellectual and/or developmental disabilities, an intermediate care facility (ICF-IDD).

Nursing homes and ICF-IDDs provide care for people who cannot safely care for themselves at home and need assistance with daily activities, including dressing, bathing, eating, grooming, and taking medications

The Ohio Long-Term Care Consumer Guide is available to help individuals and families identify appropriate care settings based on their specific needs.

There are also alternatives to institutional care. Medicaid has several programs for people with extensive care needs who would prefer to receive services in their home and community.

There are also alternatives to institutional care. Medicaid offers several programs for people with significant care needs who prefer to receive services in their home or community.

Ohio Medicaid’s Estate Recovery Program seeks repayment for Medicaid services provided to individuals who were permanently institutionalized or age 55 and older once they pass away. Recovery is taken from the person’s estate, which includes all real and personal property, after certain conditions are met, such as having no surviving spouse or qualifying child. The Ohio Attorney General’s Office files the claim, and the estate’s executor is responsible for notifying them and informing affected heirs. Some exceptions may apply in cases of undue hardship, and a home may be subject to recovery under specific rules.

Additional information is available in the ODM 07400 Ohio Medicaid Estate Recovery information flyer.

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Application process

When applying for institutional care through Medicaid, applicants will need to show proof of income, resources (or assets), disability, U.S. citizenship or qualified alien status, and other health insurance. Individuals must also meet Transfer of Resources provisions. 

A Level of Care (LOC) assessment is required, and once the individual’s care needs are determined, an additional calculation is completed to establish how much of their income will be applied to the cost of institutional care. This amount is called the Patient Liability.

How will this affect family members?

If an individual needs institutional care and has a spouse or dependent family members, it is possible for some of that individual’s income and assets to be reserved to support the dependents remaining in the home. This is known as the Spousal Impoverishment Law, established as a provision of the Medicare Catastrophic Coverage Act (MCCA) of 1988.

How it works

A resource assessment is conducted to determine the amount that will be given to the spouse and dependents at home. In 2025 in Ohio, the maximum resource amount a spouse or dependent family member may keep is $157,920, and the maximum monthly maintenance allowance is $3,948 (these figures change annually). In addition, the Spousal Impoverishment Law allows one year for the institutionalized spouse to transfer assets to the community spouse, after which patient liability is determined.

Anyone can apply for Nursing Home or Institutional Care Medicaid by completing a JFS 07200 Request for Cash, Food and Medical Assistance application. You can submit your application online, fax it to 866-351-8292, mail or bring it to 1180 S. Main Street, Suite 102, Akron, OH 44301, email it to This email address is being protected from spambots. You need JavaScript enabled to view it., or call 844-640-6446 and follow the prompts to select long-term care.

Medicare Assistance Programs

Medicare Part A (for hospital) and Part B (for medical) have associated premiums, deductibles, and co-payments. The Medicare program was never designed to pay medical costs in full. The Medicaid Program can act as a Medigap payer to help some eligible Medicare recipients with these costs.

QMB

Qualified Medicare Beneficiaries (QMB) whose income (after exclusions) does not exceed 100% of the Federal Poverty Level (currently $1,255 for an individual and $1,704 for a married couple) are entitled to have the Medicaid program pay their Part B premium ($185.00 in 2025) and all other costs and deductibles not paid by Medicare. Applicants aged 65 who have SSI income and are not eligible for free Part A may be eligible for Medicaid to pay the Part A hospital premium.

SLMB

Specified Low–Income Medicare Beneficiaries (SLMB) whose income does not exceed 120% of the Federal Poverty Level (currently $1,506 for an individual and $2,044 for a married couple) are entitled to have the Medicaid program pay their Part B premium ($185.00 for 2025).

*The current QMB/SLMB resource limit is $9,600 for an individual and $14,4701 for a married couple.

QI-1

Qualified Individual (QI) program helps Medicare-eligible applicants who do not qualify for QMB or SLMB (and whose income is does not exceed $1,695 for an individual and $2,300 for a married couple) are eligible for Medicaid to pay their Part B premium only.