How to apply for Assisted Living Medicaid Waiver in Ohio

Who it's for

The Assisted Living Medicaid Waiver pays for care in an assisted living facility that is licensed as a residential care facility by the Ohio Department of Health and certified by the Ohio Department of Aging. It is an alternative to nursing facility care that is less expensive and less restrictive. Covered services include 24-hour on-site response, personal care, housekeeping, laundry and maintenance, nursing, transportation, three meals a day, and social and recreational programming. Community Transition Services help people leaving a nursing facility get essential household furnishings. To qualify you must be 21 or older, need hands-on help with activities of daily living such as bathing or moving around, meet Medicaid financial rules, and be able to pay the state-set monthly room and board charge. Countable assets must be $2,000 or less, and monthly income must not be more than 300 percent of the Supplemental Security Income benefit. Depending on income, you may have to pay something each month toward the cost of services. Call 1-866-243-5678 to reach the Area Agency on Aging for your area.

What you'll need

• Proof of age 21 or older
• Proof of Ohio residency
• Proof of all income and countable assets
• In-person level-of-care assessment showing a hands-on need for help with activities of daily living
• Medicare card if enrolled

Where to apply

What to say when you call

"Hello, I'm calling to ask about Assisted Living Medicaid Waiver. I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need proof of age 21 or older, proof of Ohio residency, proof of all income and countable assets — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Gather your required documents: proof of age (21 or older), proof of Ohio residency, proof of all income and countable assets, and your Medicare card if you are enrolled in Medicare.
2. Contact your local Area Agency on Aging by calling 1-866-243-5678 or applying online to start the process. The representative can guide you to the right office for your county.
3. Schedule and complete an in-person level-of-care assessment. A professional will visit to confirm you need hands-on help with daily activities such as bathing or moving around.
4. Submit your financial documents to your County Department of Job and Family Services. They will determine whether you meet Medicaid financial rules, including the asset and income limits.
5. Work with your Area Agency on Aging to identify an assisted living facility that is licensed as a residential care facility by the Ohio Department of Health and certified by the Ohio Department of Aging.
6. Be prepared to pay the state-set monthly room and board charge out of your own income. Depending on your income, you may also owe a monthly payment toward the cost of services.
7. Complete any remaining paperwork requested by your Area Agency on Aging or County Department of Job and Family Services to finalize your enrollment.

What to expect: After submitting your application and assessment results, your County Department of Job and Family Services will review your financial eligibility while your Area Agency on Aging coordinates your level-of-care review. Processing times vary, so ask your Area Agency on Aging representative for an estimate. If approved, you will be enrolled in the waiver and can begin receiving covered services — including personal care, nursing, meals, housekeeping, transportation, and social programming — at your certified assisted living facility. If you are leaving a nursing facility, ask about Community Transition Services, which can help with essential household furnishings. Enrollment is reviewed annually, so be ready to provide updated income, asset, and residency information each year to keep your coverage active.

Renewals

annual