Ohio’s expanded Medicaid eligibility covers adults ages 19 through 64 with household income up to 138% of the federal poverty level, which comes out to roughly $22,025 a year for a single person under the 2026 guidelines. You do not need dependent children, a disability, or any particular level of savings to qualify. About 760,000 Ohioans are enrolled through the expansion, most of whom had no way into Medicaid before the state adopted it in January 2014.
Who Qualifies
The expansion group is adults 19 through 64 who are not eligible for Medicare. Eligibility turns on your Modified Adjusted Gross Income compared to the federal poverty level. The practical cutoff is 138% of FPL. Ohio’s official documents sometimes list 133% because a separate 5% income disregard is applied on top, and the two together produce the 138% figure most people see quoted.
Before expansion, Ohio Medicaid was largely closed to childless adults no matter how low their income. That gap is gone. If you’re an adult under 65 and your household income fits within the limit, you can qualify whether or not you have kids.
There is no asset or resource test for the expansion group. Owning a car or having money in a savings account does not disqualify you. Eligibility rests on income and household size alone.
2026 Income Limits by Household Size
Federal poverty guidelines update each year and Medicaid’s limits move with them. At 138% of the 2026 guidelines, the approximate annual income ceilings are:1HHS ASPE. 2026 Poverty Guidelines – 48 Contiguous States
- 1 person: about $22,025
- 2 people: about $29,863
- 3 people: about $37,702
- 4 people: about $45,540
Each additional household member adds roughly $7,838. If your income fluctuates from month to month, eligibility is typically assessed on projected annual income rather than a single pay stub.
Higher Limits for Pregnant Women, Children, and Parents
The expansion group is not the only path in. If you fall outside its income limit, check whether one of these tracks fits your situation:2Ohio Department of Medicaid. Ohio Medicaid 2026 Monthly Financial Eligibility – Children, Families, and Adults
- Pregnant women: up to 200% of FPL, with coverage continuing through the postpartum period regardless of income changes
- Uninsured children: up to 206% of FPL, with additional options through Ohio’s CHIP program at higher income levels
- Parents and caretaker relatives: a lower threshold, around 90% of FPL
Non-Citizen Eligibility
Immigration status matters. “Qualified” non-citizens eligible for full Medicaid include lawful permanent residents, refugees, asylees, individuals granted withholding of deportation, and Cuban and Haitian entrants, along with other categories set out in Ohio’s administrative code.3Ohio Legislative Service Commission. Rule 5160:1-2-12 – Medicaid: Non-Citizens
Most lawful permanent residents must wait five years after getting their green card before qualifying for full benefits. Refugees, asylees, and veterans are among the groups exempt from that wait. Emergency Medicaid is available to non-citizens regardless of immigration status when a medical emergency occurs.
What Expanded Medicaid Covers
Ohio’s managed care benefit package covers:4Ohio Department of Medicaid. Medicaid Managed Care Benefit Package
- Inpatient and outpatient hospital care
- Doctor and specialist visits, up to 24 per 12-month period, with additional visits for specified conditions5Ohio Department of Medicaid. Professional Medical Services
- Prescription drugs
- Behavioral health, including mental health and substance use disorder treatment
- Preventive care: screenings, immunizations, wellness visits
- Emergency and ambulance services
- Dental, vision, and hearing services
- Physical, occupational, and speech therapy
- Home health and durable medical equipment
Most services for expansion-group adults carry no copay at the point of care. Ohio Medicaid does charge small copays for certain services, but providers cannot turn you away for inability to pay one.
How to Apply
Three channels are available:
- Online through the Ohio Benefits Self-Service Portal at benefits.ohio.gov
- By phone at the Ohio Medicaid Consumer Hotline, 1-800-324-8680 (Monday through Friday 7 a.m. to 8 p.m., Saturday 8 a.m. to 5 p.m. ET)
- In person at your local County Department of Job and Family Services office
You’ll need proof of income (pay stubs, tax returns, or a letter from your employer), your Social Security number, information about everyone in your household, and documentation of Ohio residency. If some documents aren’t ready, submit what you have and respond to any follow-up letter the agency sends.
After You Apply
Processing Time
Federal rules give the state 45 calendar days to process a standard Medicaid application and 90 days for disability-based applications.6eCFR. 42 CFR 435.912 – Timely Determination of Eligibility Straightforward expansion applications often move faster, especially when filed online with complete documents.
Ohio Medicaid can also cover unpaid medical bills from the three months before the month you applied, if you were eligible during that time. Ask for retroactive coverage as part of your application.
Managed Care Plan Selection
Once approved, you’ll be enrolled with one of Ohio’s seven managed care plans:
- AmeriHealth Caritas Ohio
- Anthem Blue Cross and Blue Shield
- Buckeye Health Plan
- CareSource Ohio
- Humana Healthy Horizons in Ohio
- Molina Healthcare of Ohio
- UnitedHealthcare Community Plan of Ohio
You can pick a plan at enrollment; if you don’t, one is assigned. During your first 90 days you can switch freely. After that, changes happen at annual open enrollment in November or for “just cause” if you’re having trouble getting care.7Ohio Medicaid Consumer Hotline. Ohio Medicaid Managed Care FAQ You’ll get a Medicaid ID card and a separate managed care plan card.
If You’re Denied
A denial notice will state the reason. You have the right to a state fair hearing, and the state generally must decide within 90 days of your request.8Medicaid.gov. Understanding Medicaid Fair Hearings Common reasons include income over the limit or missing paperwork. Some denials can be fixed by resubmitting the right documents rather than by going to a hearing.
Work Requirement Starting in 2027
The biggest change on the horizon: no later than January 1, 2027, some expansion-group members will need to show at least 80 hours a month of work, volunteering, job training, or half-time schooling to keep coverage.9Ohio Department of Medicaid. Medicaid Group VIII Work and Community Engagement Requirement FAQ Any combination of those activities can add up to the 80 hours. The state plans outreach to affected members between June 30 and August 31, 2026.
Broad exemptions apply, including:
- Anyone under 19 or over 65
- Pregnant or postpartum individuals
- People with disabilities or serious medical conditions
- Caregivers of children 13 or younger, or of disabled dependents
- People already meeting SNAP or TANF work requirements
- Individuals in substance use disorder treatment
- People released from incarceration within the past 3 months
- Native Americans
If you get a non-compliance notice, you’ll have 30 days to demonstrate you meet the requirement or qualify for an exemption before coverage ends. CMS is expected to issue further regulations in June 2026 that may refine these rules.
Keeping Your Coverage
Approval isn’t the end of the process. Most expansion-group adults have their eligibility redetermined annually. A renewal packet arrives by mail or electronic notification, and the response deadline is typically 30 to 60 days. Missing it can cause a coverage gap and leave you responsible for medical bills during the lapse.
Between renewals, you’re required to report certain changes within 10 days:
- Income changes, including a new job, a raise, or a job loss
- Changes in household size, such as a new baby or someone moving out
- Address changes
Returned mail is one of the most common reasons people lose coverage they still qualify for. Updating your address through the Ohio Benefits portal takes a few minutes.
Estate Recovery for Enrollees 55 and Older
One boundary is worth knowing before you enroll if you’re older. After a Medicaid beneficiary dies, Ohio may seek repayment from their estate for benefits paid, either because the person was permanently institutionalized at any age, or because they were 55 or older when they received benefits.10Ohio Legislative Service Commission. Rule 5160:1-2-07 – Medicaid: Estate Recovery
For enrollees in their 20s, 30s, or 40s, this isn’t an immediate concern. Between 55 and 64, every dollar spent on your care is potentially recoverable from your estate after you die, and Ohio defines “estate” broadly to include joint tenancy property, living trusts, and life estates in addition to probate assets.
Recovery is delayed or blocked when a surviving spouse is alive; when a surviving child is under 21, blind, or permanently disabled; when a qualifying sibling has lived in the home for at least a year before the beneficiary entered a nursing facility and still lives there; or when a son or daughter lived in the home for at least two years before institutionalization, provided care that delayed admission, and still lives there. Ohio also disregards amounts covered by qualifying long-term care insurance partnerships, and hardship waivers exist by separate application.