Medicare Ratings Guide

Author: Dr. Patricia Chen

  • Medicaid Eligibility in Utah 2026: Income Limits, Requirements & How to Apply

    Medicaid in Utah: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) 138% FPL = $1,831/month 138% FPL = $2,480/month

    Medicaid Expansion Status in Utah

    Utah has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Who Qualifies for Medicaid in Utah?

    Medicaid in Utah covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (if the state has expanded Medicaid).

    Medicaid for Seniors (65+) in Utah

    Seniors in Utah may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Utah is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Utah

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Utah. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in Utah

    You can apply for Medicaid in Utah through the following channels:

    • Online: Through Utah’s state Medicaid portal or HealthCare.gov
    • Phone: Call Utah’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Utah

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Utah, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 86,400 dual-eligible individuals in Utah.

    Medicaid Asset Limits in Utah

    In addition to income limits, Medicaid for long-term care in Utah has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in Texas 2026: Income Limits, Requirements & How to Apply

    Medicaid in Texas: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) Not available (state not expanded) Not available

    Medicaid Expansion Status in Texas

    Texas has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 15% FPL ($4,098/year for a family of three) may qualify.

    Who Qualifies for Medicaid in Texas?

    Medicaid in Texas covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (limited eligibility in non-expansion states).

    Medicaid for Seniors (65+) in Texas

    Seniors in Texas may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Texas is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Texas

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Texas. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in Texas

    You can apply for Medicaid in Texas through the following channels:

    • Online: Through Texas’s state Medicaid portal or HealthCare.gov
    • Phone: Call Texas’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Texas

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Texas, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 842,400 dual-eligible individuals in Texas.

    Medicaid Asset Limits in Texas

    In addition to income limits, Medicaid for long-term care in Texas has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in Tennessee 2026: Income Limits, Requirements & How to Apply

    Medicaid in Tennessee: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) Not available (state not expanded) Not available

    Medicaid Expansion Status in Tennessee

    Tennessee has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 105% FPL ($28,686/year for a family of three) may qualify.

    Who Qualifies for Medicaid in Tennessee?

    Medicaid in Tennessee covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (limited eligibility in non-expansion states).

    Medicaid for Seniors (65+) in Tennessee

    Seniors in Tennessee may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Tennessee is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Tennessee

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Tennessee. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in Tennessee

    You can apply for Medicaid in Tennessee through the following channels:

    • Online: Through Tennessee’s state Medicaid portal or HealthCare.gov
    • Phone: Call Tennessee’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Tennessee

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Tennessee, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 259,200 dual-eligible individuals in Tennessee.

    Medicaid Asset Limits in Tennessee

    In addition to income limits, Medicaid for long-term care in Tennessee has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in South Dakota 2026: Income Limits, Requirements & How to Apply

    Medicaid in South Dakota: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) 138% FPL = $1,831/month 138% FPL = $2,480/month

    Medicaid Expansion Status in South Dakota

    South Dakota has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Who Qualifies for Medicaid in South Dakota?

    Medicaid in South Dakota covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (if the state has expanded Medicaid).

    Medicaid for Seniors (65+) in South Dakota

    Seniors in South Dakota may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in South Dakota is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in South Dakota

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in South Dakota. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in South Dakota

    You can apply for Medicaid in South Dakota through the following channels:

    • Online: Through South Dakota’s state Medicaid portal or HealthCare.gov
    • Phone: Call South Dakota’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in South Dakota

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In South Dakota, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 36,000 dual-eligible individuals in South Dakota.

    Medicaid Asset Limits in South Dakota

    In addition to income limits, Medicaid for long-term care in South Dakota has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in South Carolina 2026: Income Limits, Requirements & How to Apply

    Medicaid in South Carolina: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) Not available (state not expanded) Not available

    Medicaid Expansion Status in South Carolina

    South Carolina has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 67% FPL ($18,304/year for a family of three) may qualify.

    Who Qualifies for Medicaid in South Carolina?

    Medicaid in South Carolina covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (limited eligibility in non-expansion states).

    Medicaid for Seniors (65+) in South Carolina

    Seniors in South Carolina may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in South Carolina is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in South Carolina

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in South Carolina. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in South Carolina

    You can apply for Medicaid in South Carolina through the following channels:

    • Online: Through South Carolina’s state Medicaid portal or HealthCare.gov
    • Phone: Call South Carolina’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in South Carolina

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In South Carolina, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 201,600 dual-eligible individuals in South Carolina.

    Medicaid Asset Limits in South Carolina

    In addition to income limits, Medicaid for long-term care in South Carolina has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in Rhode Island 2026: Income Limits, Requirements & How to Apply

    Medicaid in Rhode Island: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $1,118/month $1,677/month
    ACA Expansion (working-age adults) 138% FPL = $1,831/month 138% FPL = $2,480/month

    Medicaid Expansion Status in Rhode Island

    Rhode Island has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Who Qualifies for Medicaid in Rhode Island?

    Medicaid in Rhode Island covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (if the state has expanded Medicaid).

    Medicaid for Seniors (65+) in Rhode Island

    Seniors in Rhode Island may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Rhode Island is $1,118/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Rhode Island

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Rhode Island. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $1,118/month.

    How to Apply for Medicaid in Rhode Island

    You can apply for Medicaid in Rhode Island through the following channels:

    • Online: Through Rhode Island’s state Medicaid portal or HealthCare.gov
    • Phone: Call Rhode Island’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Rhode Island

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Rhode Island, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 46,800 dual-eligible individuals in Rhode Island.

    Medicaid Asset Limits in Rhode Island

    In addition to income limits, Medicaid for long-term care in Rhode Island has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in Pennsylvania 2026: Income Limits, Requirements & How to Apply

    Medicaid in Pennsylvania: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) 138% FPL = $1,831/month 138% FPL = $2,480/month

    Medicaid Expansion Status in Pennsylvania

    Pennsylvania has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Who Qualifies for Medicaid in Pennsylvania?

    Medicaid in Pennsylvania covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (if the state has expanded Medicaid).

    Medicaid for Seniors (65+) in Pennsylvania

    Seniors in Pennsylvania may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Pennsylvania is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Pennsylvania

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Pennsylvania. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in Pennsylvania

    You can apply for Medicaid in Pennsylvania through the following channels:

    • Online: Through Pennsylvania’s state Medicaid portal or HealthCare.gov
    • Phone: Call Pennsylvania’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Pennsylvania

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Pennsylvania, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 554,400 dual-eligible individuals in Pennsylvania.

    Medicaid Asset Limits in Pennsylvania

    In addition to income limits, Medicaid for long-term care in Pennsylvania has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in Oregon 2026: Income Limits, Requirements & How to Apply

    Medicaid in Oregon: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $1,118/month $1,677/month
    ACA Expansion (working-age adults) 138% FPL = $1,831/month 138% FPL = $2,480/month

    Medicaid Expansion Status in Oregon

    Oregon has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Who Qualifies for Medicaid in Oregon?

    Medicaid in Oregon covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (if the state has expanded Medicaid).

    Medicaid for Seniors (65+) in Oregon

    Seniors in Oregon may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Oregon is $1,118/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Oregon

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Oregon. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $1,118/month.

    How to Apply for Medicaid in Oregon

    You can apply for Medicaid in Oregon through the following channels:

    • Online: Through Oregon’s state Medicaid portal or HealthCare.gov
    • Phone: Call Oregon’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Oregon

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Oregon, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 165,600 dual-eligible individuals in Oregon.

    Medicaid Asset Limits in Oregon

    In addition to income limits, Medicaid for long-term care in Oregon has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in Oklahoma 2026: Income Limits, Requirements & How to Apply

    Medicaid in Oklahoma: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) 138% FPL = $1,831/month 138% FPL = $2,480/month

    Medicaid Expansion Status in Oklahoma

    Oklahoma has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Who Qualifies for Medicaid in Oklahoma?

    Medicaid in Oklahoma covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (if the state has expanded Medicaid).

    Medicaid for Seniors (65+) in Oklahoma

    Seniors in Oklahoma may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Oklahoma is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Oklahoma

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Oklahoma. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in Oklahoma

    You can apply for Medicaid in Oklahoma through the following channels:

    • Online: Through Oklahoma’s state Medicaid portal or HealthCare.gov
    • Phone: Call Oklahoma’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Oklahoma

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Oklahoma, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 147,600 dual-eligible individuals in Oklahoma.

    Medicaid Asset Limits in Oklahoma

    In addition to income limits, Medicaid for long-term care in Oklahoma has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.

  • Medicaid Eligibility in Ohio 2026: Income Limits, Requirements & How to Apply

    Medicaid in Ohio: 2026 Income Limits

    Medicaid Program Single Person Married Couple
    Nursing Home / Institutional Medicaid $2,982/month $5,964/month
    HCBS Waiver (home-based care) $2,982/month $5,964/month
    Regular Medicaid (Aged, Blind, Disabled) $994/month $1,491/month
    ACA Expansion (working-age adults) 138% FPL = $1,831/month 138% FPL = $2,480/month

    Medicaid Expansion Status in Ohio

    Ohio has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Who Qualifies for Medicaid in Ohio?

    Medicaid in Ohio covers several distinct groups, each with different income and eligibility requirements. The major categories are: seniors (65+), people with disabilities, pregnant women, children, and low-income adults (if the state has expanded Medicaid).

    Medicaid for Seniors (65+) in Ohio

    Seniors in Ohio may qualify for Medicaid to cover nursing home care, home-based care, or to supplement Medicare coverage. The income limit for Regular Medicaid (Aged, Blind, and Disabled) in Ohio is $994/month for a single person. For nursing home care, the limit is $2,982/month.

    Medicaid for People with Disabilities in Ohio

    People with disabilities who receive SSDI or SSI may qualify for Medicaid in Ohio. SSI recipients automatically qualify for Medicaid in most states. SSDI recipients must wait 24 months for Medicare, during which Medicaid may provide coverage if income is below $994/month.

    How to Apply for Medicaid in Ohio

    You can apply for Medicaid in Ohio through the following channels:

    • Online: Through Ohio’s state Medicaid portal or HealthCare.gov
    • Phone: Call Ohio’s Medicaid office directly
    • In person: Visit your local Department of Social Services or Medicaid office
    • Mail: Download and mail a paper application

    Medicaid and Medicare Dual Eligibility in Ohio

    Individuals who qualify for both Medicare and Medicaid are called “dual eligibles.” In Ohio, dual eligible individuals receive comprehensive coverage: Medicare covers most medical services, while Medicaid covers Medicare premiums, deductibles, copays, and additional services like long-term care. There are approximately 482,400 dual-eligible individuals in Ohio.

    Medicaid Asset Limits in Ohio

    In addition to income limits, Medicaid for long-term care in Ohio has asset limits. For a single applicant, the countable asset limit is typically $2,000. For a married couple where one spouse needs nursing home care, the community spouse may keep up to $157,920 in countable assets (the Community Spouse Resource Allowance, or CSRA, for 2026). The primary home, one vehicle, personal belongings, and certain other assets are typically exempt.