Ohio Medicaid eligibility turns on three things: whether you’re an Ohio resident with U.S. citizenship or qualified immigration status, which category you fit (child, pregnant, parent, adult 19–64, or aged/blind/disabled), and whether your household income — and sometimes your assets — fall under the limit for that category. For a single working-age adult, that income limit is roughly $22,025 a year in 2026. Children and pregnant women qualify at much higher incomes. Seniors and people with disabilities face a separate test that also looks at savings and other resources.
Income Limits by Category
For children, pregnant women, parents, and adults aged 19 to 64, Ohio uses Modified Adjusted Gross Income (MAGI). Under MAGI, your savings, home equity, and other assets don’t count. Only your household income does.1Ohio Department of Medicaid. Who Qualifies
Each group has its own ceiling tied to the Federal Poverty Level (FPL). In 2026, the FPL is $15,960 a year for one person and $33,000 for a family of four.2U.S. Department of Health and Human Services. 2026 Poverty Guidelines – 48 Contiguous States Ohio’s major MAGI thresholds for 2026 are:3Ohio Department of Medicaid. 2026 Monthly Financial Eligibility – Children, Families, and Adults
- Expansion adults, ages 19 to 64 without dependent children: income at or below 133% FPL (effectively 138% after a built-in 5% disregard), about $22,025 a year or $1,835 a month for a single person, and roughly $45,540 a year for a family of four.
- Parents and caretaker relatives: income at or below 90% FPL for the household size.
- Pregnant women: income at or below 200% FPL, about $31,920 a year for one person or $43,280 for a household of two.
- Children with other health insurance: income at or below 156% FPL.
- Children without other health insurance: income at or below 206% FPL.
Because the ceilings for children and pregnant women sit well above the adult ceiling, a family can earn too much for the parents to enroll while the children still qualify, or while the pregnant parent qualifies for pregnancy-related coverage.
If You’re 65 or Older, Blind, or Have a Disability
A separate track covers people who are 65 or older, legally blind, or have a disability as classified by the Social Security Administration. This is the Aged, Blind, and Disabled (ABD) category.4Ohio Department of Medicaid. Aged, Blind, or Disabled (ABD) Medicaid ABD applicants face both an income limit and a resource limit.
Resource Limits
In 2026, an individual applying under ABD can hold no more than $2,000 in countable resources. A married couple is capped at $3,000.5Ohio Legislative Service Commission. Ohio Administrative Code Rule 5160:1-3-05.1 – Medicaid Resource Requirement Countable resources include bank accounts, stocks, bonds, and any vehicles beyond your primary car. Your home (if you live in it), one vehicle, and household furnishings are generally exempt.6Ohio Department of Medicaid. 2026 Medicaid Standards Help Sheet Up to $1,500 per person in designated burial funds is excluded, and irrevocable prepaid burial contracts are fully excluded.7Ohio Legislative Service Commission. Ohio Administrative Code Rule 5160:1-3-05.6 – Medicaid Burial Funds and Contracts
Income Cap for Nursing Home Care and the Qualified Income Trust
If you need nursing-home-level care but your monthly income is above 300% of the federal SSI benefit, you can still qualify by routing the excess through a Qualified Income Trust (sometimes called a Miller Trust). For 2026, the SSI benefit is $994 a month, which puts the institutional Medicaid income cap at $2,982 a month.8Social Security Administration. SSI Federal Payment Amounts for 2026 The trust directs income above that cap into a special account so your countable income drops below the threshold. An attorney who handles Medicaid planning can set it up correctly.
Spousal Protections When One Spouse Enters a Facility
When one spouse needs institutional care and the other stays at home, the at-home spouse isn’t required to spend down everything. For 2026, the at-home spouse can keep between $32,532 and $162,660 in countable resources depending on the couple’s total holdings, and is entitled to a minimum monthly income allowance capped at $4,066.50.9Ohio Department of Medicaid. Spousal Impoverishment Standards Adjustments for 2026 COLA These protections apply automatically; you don’t need to divorce or separate your finances.
Medicaid Buy-In for Workers with Disabilities
If you have a recognized disability and you work, the Medicaid Buy-In for Workers with Disabilities (MBIWD) program lets you keep coverage despite earnings. You must have a disability recognized by the Social Security Administration or Ohio Medicaid, be employed, and have monthly income at or below 250% of the FPL, which is roughly $3,325 a month for a single person in 2026.10Ohio Department of Medicaid. Medicaid Buy-In for Workers with Disabilities
Residency and Citizenship
You must be an Ohio resident who intends to stay in the state.1Ohio Department of Medicaid. Who Qualifies You also must be a U.S. citizen or a qualified non-citizen, and your status is verified electronically during the application.11Cornell Law School. Ohio Administrative Code 5160:1-2-10 – Medicaid Conditions of Eligibility and Verifications
Lawful Permanent Residents generally wait five years from the date they received their qualifying immigration status before they can enroll. Refugees, asylees, and veterans or active-duty military members with qualified non-citizen status are exempt from the five-year wait and can apply right away.12Centers for Medicare and Medicaid Services. Immigrant Eligibility for Marketplace and Medicaid and CHIP Coverage
A Possible New Requirement for Expansion Adults
Ohio has submitted a federal waiver that, if approved, would add enrollment conditions for Group VIII expansion adults (ages 19 to 64 who qualify on income alone). An expansion adult would need to meet at least one of these: be at least 55, be employed, be in school or occupational training, be in a substance-use treatment program, or have intensive medical needs or a serious mental illness.13Centers for Medicare and Medicaid Services. Group VIII 1115 Demonstration Waiver Application
The state submitted the waiver in February 2025 with a placeholder start date of January 1, 2026. Implementation depends on federal approval, and Ohio has said it plans to verify most criteria through existing data systems rather than through regular reports from enrollees. If you qualify as an expansion adult, watch for notices from the Ohio Department of Medicaid about any changes.
What Estate Recovery Means for Older Enrollees
Ohio runs a Medicaid estate recovery program that can seek repayment after you die. Recovery applies if you were permanently institutionalized or if you were 55 or older when you received Medicaid-covered services, and the state can pursue payments made since January 1995.14Ohio Department of Medicaid. Ohio Medicaid Estate Recovery
Recovery doesn’t happen while certain family members survive. The state won’t pursue a claim against your estate if you have a surviving spouse, a surviving child under 21, or a surviving child of any age who is blind or disabled. Otherwise the state may file a claim against your estate, including the value of your home. An undue hardship waiver may delay or eliminate the claim on a case-by-case basis if a survivor would be deprived of basics like food, shelter, or needed medical care.
If You’re Denied
If your application is denied or your benefits are reduced, the written notice includes a form to request a state hearing. You have 90 days from the mailing date of the notice to submit that request.15Ohio Medicaid Consumer Hotline. Appeals If you’re already enrolled and get a notice that coverage will be reduced or ended, requesting a hearing within 15 days of receiving the notice lets you keep your current benefits until the hearing is decided.
You can submit the request by mailing the form that came with your notice or by contacting the Bureau of State Hearings directly.16Ohio Department of Developmental Disabilities. Medicaid Appeals Miss the 15-day or 90-day window and you lose the right to challenge that decision; you’d need to reapply or wait for a new determination.