Ohio Medicaid waiver guide
Last checked: May 18, 2026
Ohio Medicaid HCBS waivers may help pay for care at home or in another community setting when a person would otherwise need nursing facility, hospital, or other institutional care. The right path depends on age, disability, Medicaid status, Medicare status, and the kind of help needed.
For many older adults, the first call is the Area Agency on Aging or PASSPORT Administrative Agency. For a child or adult under 60 with a physical disability or unstable medical needs, the first step is often Ohio Medicaid, the county Department of Job and Family Services, or the Ohio Home Care Waiver request form.
Quick answer
Ohio has several Medicaid HCBS waiver routes. PASSPORT is the main home-care waiver route for many people age 60 or older. The Ohio Home Care Waiver is for people from birth through age 59 with physical disabilities who meet the waiver rules. MyCare Ohio has a waiver route for people enrolled in MyCare Ohio who need a nursing facility level of care.
Family caregiver payment is possible in some cases, but it is not automatic. Ask about self-direction, PASSPORT participant direction, and Structured Family Caregiving. Rules about spouses, parents, guardians, powers of attorney, and other relatives are strict, so confirm before planning on payment.
Start here
- If the person is age 60 or older: call the Area Agency on Aging at 1-866-243-5678 and ask for a PASSPORT screening or the PASSPORT Administrative Agency for your county.
- If the person is under 60 and has a physical disability or unstable medical needs: ask Ohio Medicaid or your county Department of Job and Family Services about the Ohio Home Care Waiver and form ODM 02399.
- If the person has both Medicare and Medicaid: ask whether they are in MyCare Ohio and who their waiver service coordinator or MyCare plan contact is.
If the first person says no, ask, “Which program did you screen for, and can you tell me the appeal or next-step process in writing?”
Ohio rules can change
Counties, managed care plans, waiver contractors, and local agencies may use different names for the same kind of help. A case may also move from one route to another when the person turns 60, gets Medicare, moves counties, enters a nursing facility, or loses a primary caregiver. Confirm all details with Ohio Medicaid, the Ohio Department of Aging, the Area Agency on Aging, the MyCare plan, or the county office before you act.
Main Ohio routes at a glance
| Program or route | Who it may help | Where to start |
|---|---|---|
| PASSPORT Medicaid Waiver | People age 60 or older who qualify for Medicaid, need a nursing facility level of care, and can be served safely at home or in another community setting. | Call the Area Agency on Aging at 1-866-243-5678 and ask for a PASSPORT screening. |
| Ohio Home Care Waiver | People from birth through age 59 with physical disabilities who meet Medicaid and level-of-care rules. | Contact Ohio Medicaid, your county Department of Job and Family Services, or submit ODM 02399, Request for Medicaid Home and Community-Based Services Waiver. |
| MyCare Ohio Waiver | People enrolled in MyCare Ohio who meet nursing facility level-of-care rules and need waiver services. | Contact the MyCare plan, waiver service coordinator, or Ohio Medicaid Consumer Hotline at 800-324-8680. |
| Assisted Living Waiver | People who need a residential care facility setting instead of home care. This is not the same as care in a private home. | Ask the Area Agency on Aging or PASSPORT Administrative Agency about Assisted Living Waiver screening. |
| Developmental Disabilities waivers | People with intellectual or developmental disabilities. Ohio has Individual Options, Level One, and SELF waivers. | Contact the county board of developmental disabilities. |
| OhioRISE Waiver | Children and youth with serious emotional disturbance and complex behavioral health or multi-system needs. | Ask OhioRISE, Aetna Better Health of Ohio, or the child’s care coordinator about waiver screening. |
What an HCBS waiver is
HCBS means Home and Community-Based Services. It is Medicaid language for help that can be given at home or in another community setting instead of a nursing facility, hospital, or other institution.
A waiver is not a cash grant. It is not a promise that a family member will be paid. It is a Medicaid program that can approve certain services when the person meets both financial rules and care-needs rules.
Most waiver decisions look at two main things:
- Medicaid eligibility: income, resources, citizenship or qualified immigration status, and other Medicaid rules.
- Level of care: whether the person’s health and daily-care needs are high enough for the waiver. For many Ohio routes, this means a nursing facility level of care. Some routes use other level-of-care rules.
If Medicaid rules are new to you, read Medicaid HCBS Waivers Explained. If the person has too much income for regular Medicaid, also read Medicaid Spend Down. If assets were transferred, read Medicaid Look-Back Period.
Main waivers in Ohio
PASSPORT
PASSPORT is the main Ohio Medicaid home-care waiver route for many older adults. It is run day to day by the Ohio Department of Aging through local partners. A person must be age 60 or older at enrollment, qualify for Medicaid, need a nursing facility level of care, and be able to have needs met safely in a home or community setting.
PASSPORT starts with screening and assessment. The local agency checks whether the person may qualify for Medicaid and how much help the person may need. If approved, a case manager helps build a care plan.
Ask for PASSPORT if the person needs help with bathing, dressing, meals, mobility, safety checks, adult day care, respite, home changes, meals, or other long-term services at home.
Ohio Home Care Waiver
The Ohio Home Care Waiver is run by the Ohio Department of Medicaid. It is for people from birth through age 59 who have physical disabilities and meet the program rules. The person must qualify for Ohio Medicaid, take part in an in-person assessment, meet nursing facility level-of-care rules, and need waiver help to avoid hospital or nursing facility care.
This route may matter for medically fragile children, adults with serious physical disabilities, or people who need skilled or personal care at home. When a person turns 60, Ohio rules say the person may be offered a chance to move to PASSPORT if they meet PASSPORT rules.
MyCare Ohio Waiver
MyCare Ohio is for many Ohioans who have both Medicare and Medicaid. The MyCare Ohio Waiver is for members who are enrolled in MyCare Ohio and meet waiver rules, including nursing facility level of care and a need for waiver services.
As of 2026, Ohio is using the Next Generation MyCare program. The program began in the counties where MyCare Ohio was already available, with statewide growth planned during 2026. Because this rollout may affect plan names, contacts, and service coordination, ask Ohio Medicaid or the MyCare plan to confirm what applies in the person’s county.
Assisted Living Waiver
The Assisted Living Waiver is not the same as getting care in a private home. It is for people who need services in an approved residential care facility. It may still matter if the person cannot stay safely at home but may not need a nursing facility.
If the person is age 60 or older and you are unsure whether home care or assisted living is the right route, call the Area Agency on Aging and ask for long-term services and supports screening.
Developmental Disabilities and OhioRISE routes
If the person has an intellectual or developmental disability, the main route may be through the county board of developmental disabilities, not PASSPORT. Ohio’s Department of Developmental Disabilities lists the Individual Options Waiver, Level One Waiver, and SELF Waiver.
If the person is a child or youth with serious behavioral health and multi-system needs, ask about OhioRISE. OhioRISE is a different route from elder home care and physical-disability home care.
Services that may help caregivers
Waiver services depend on the program, the assessment, the care plan, available providers, and whether the service is approved for that person. Do not assume every service is covered for every person.
Personal care
Help with daily tasks such as bathing, dressing, toileting, grooming, moving around the home, eating, and safety-related support.
Homemaker and chore help
Help with household tasks that are tied to health and safety, such as meal preparation, laundry, light cleaning, and some home maintenance tasks when allowed.
Respite
Respite gives the usual caregiver a break. Ohio waiver rules may use terms like out-of-home respite. Read more at Respite Care for Caregivers.
Adult day services
Adult day care or adult day health may give the person care, meals, supervision, and activities outside the home during the day.
Home modifications
Some waivers may cover approved changes such as ramps, bathroom changes, or other changes tied to safety and access.
Transportation
Some programs include non-medical transportation or waiver transportation. Medicaid may also have transportation for covered medical care through county offices.
Meals and supplies
Some waivers may cover home-delivered meals, special meals, medical equipment, supplies, emergency response systems, or assistive devices.
Caregiver supports
Caregiver-related supports may include training, coaching, respite, care planning, participant direction, self-direction, or Structured Family Caregiving when the person meets the rules.
Before you agree to a care plan, ask the case manager or waiver service coordinator which services were considered, which were denied, and why. Keep a copy of the care plan.
Can family caregivers be paid through a waiver?
Sometimes. But the answer depends on the waiver, the service, the family relationship, and whether the caregiver is allowed to be paid under Ohio rules.
Do not quit a job or count on payment until the case manager, waiver service coordinator, plan, or agency confirms the exact route in writing.
Ask about self-direction
Self-direction means the person receiving care has more choice over who provides some services and how some services are arranged. Ohio Medicaid says self-direction is available under the Ohio Home Care Waiver and has been expanded under the MyCare Waiver.
Self-direction may involve a financial management service that helps with payment and employer tasks. The person may need to show that they can direct services, or they may need an approved representative.
Ask about PASSPORT participant direction
PASSPORT also has participant direction options. In that setup, the person may recruit and hire a provider instead of using only a personal care agency. The provider must meet Ohio Department of Aging certification rules.
Some family members may be allowed, but not every family member is allowed. Ohio Department of Aging materials say some roles, such as spouse, parent, step-parent, authorized representative, power of attorney, foster caregiver, and legal guardian, may be barred from serving as a consumer-directed provider in that route. Ask the PASSPORT case manager to check the current rule for your exact relationship.
Ask about Structured Family Caregiving
Structured Family Caregiving is a waiver service listed for PASSPORT, Ohio Home Care Waiver, and MyCare Ohio Waiver. It is for an adult waiver member who lives with a caregiver and needs daily personal care and household support. The caregiver is employed or contracted by an agency provider, and the agency provides training, coaching, and monthly contact.
Ohio rules also limit when spouses and relatives with legal decision-making authority may provide paid waiver services. The rules can depend on whether there is another willing and able provider, whether the person’s health and safety can be met, whether the care is above ordinary family care, and whether the service is written into the person-centered services plan.
Plain answer for caregivers
Ask this exact question: “Is there any approved way for a family member in my relationship to be paid for this person’s care under self-direction, PASSPORT participant direction, or Structured Family Caregiving?”
Then ask: “If yes, what agency, certification, background check, training, or financial management step is required?”
For a broader guide, see Can I Get Paid to Be a Caregiver? You can also use the caregiver pay quiz to sort possible routes.
Waitlists and priority
Waivers can have limited slots. A person may meet the care rules and still wait if no slot is open. This is one reason it is important to ask for a written notice, the program name, and the next step.
PASSPORT, Assisted Living, and PACE waiting list
Ohio has a unified waiting list rule for PASSPORT, Assisted Living, and PACE when slots or capacity are limited. If a person meets non-financial rules but a slot is not open, the person may be placed on the waiting list. Ohio’s rule says enrollment is usually offered by the order the person was placed on the list, unless another program rule applies.
PASSPORT also has a “Home First” route for certain people. Ask the PASSPORT Administrative Agency whether the person qualifies for Home First or any other priority route.
Ohio Home Care Waiver priority assessment
Ohio Home Care Waiver rules list priority categories for assessment. These include some people with long hospital stays, repeated hospital stays, long-term private duty nursing, risk of institutional care because a primary caregiver is no longer available, current Medicaid-funded nursing facility residence, or HOME Choice eligibility.
If the person has just lost a caregiver, had a long hospital stay, is in a nursing facility, or is at risk of going to one, say that clearly when you call.
Developmental Disabilities waiting lists
Developmental Disabilities waiver waiting lists are handled through county boards of developmental disabilities and separate Ohio rules. Ask the county board about emergency status, priority categories, and the person’s place on the list.
☎ What to say if you are told there is a waitlist
“Please tell me the exact waiver or program name. Is this a waiting list because there is no slot, because financial Medicaid is not approved, or because the level-of-care review is not done? Does my loved one qualify for any priority, Home First, emergency, or risk-of-institutionalization review? Can you send the decision and appeal rights in writing?”
How to apply
The best first call depends on the person’s route. If you are unsure, start with age and need.
Step 1: Pick the likely route
- Age 60 or older and needs home care: call the Area Agency on Aging at 1-866-243-5678 and ask for PASSPORT.
- Under 60 with physical disability or unstable medical needs: ask about the Ohio Home Care Waiver.
- Has both Medicare and Medicaid: ask about MyCare Ohio and whether the person has a waiver service coordinator.
- Intellectual or developmental disability: call the county board of developmental disabilities.
- Child or youth with complex behavioral health needs: ask about OhioRISE.
Step 2: Apply for Medicaid if needed
Waiver services require Medicaid eligibility. Ohio residents can apply through Ohio Benefits, by phone through the Ohio Benefits call center, or through the county Department of Job and Family Services.
Ohio Benefits lists the call center as 1-844-640-OHIO (6446). Ohio Medicaid also lists the Consumer Hotline as 800-324-8680.
Step 3: Ask for waiver screening
For PASSPORT, ask the Area Agency on Aging or PASSPORT Administrative Agency for the screening. For the Ohio Home Care Waiver, ask about form ODM 02399, Request for Medicaid Home and Community-Based Services Waiver. For MyCare Ohio, ask the plan for a waiver assessment or waiver service coordinator.
Step 4: Prepare for the assessment
The assessment should show what happens on a hard day, not only what happens when the person is rested and prepared. Be honest about falls, missed medications, wandering, toileting help, unsafe cooking, overnight needs, transfers, bathing, and caregiver burnout that affects safety.
Step 5: Get the care plan in writing
If approved, ask for the person-centered services plan. Check that it lists the services, hours or units, provider type, start date, backup plan, and who to call if workers do not show up.
☎ Phone script for Ohio caregivers
“I am caring for someone in Ohio who may need Medicaid long-term services at home. They need help with bathing, meals, mobility, medications, transportation, and safety. I want to ask for HCBS waiver screening. Can you tell me whether we should apply for PASSPORT, Ohio Home Care Waiver, MyCare Ohio Waiver, or another route? I also need to know if family caregiver payment is possible under self-direction or Structured Family Caregiving.”
Documents to gather
- Photo ID, Social Security number, birth date, address, and phone number.
- Medicaid card, Medicare card, managed care plan card, and any MyCare Ohio plan card.
- Proof of income, bank accounts, life insurance, property, and other resources.
- Health insurance cards and prescription drug coverage cards.
- Doctor names, diagnoses, medication list, hospital discharge papers, therapy notes, and nursing notes.
- List of daily tasks the person cannot do safely without help.
- Fall history, ER visits, hospital stays, nursing facility stays, or home health records.
- Proof that a primary caregiver is no longer available, if that is part of the risk.
- Power of attorney, guardianship papers, authorized representative forms, or representative payee papers, if any.
- Denial letters, waitlist letters, appeal forms, or plan notices.
Use caregiver checklists to track papers before calls and assessments.
What to do if the first answer is no
A “no” may mean many things. It may mean the person does not qualify for Medicaid. It may mean the level-of-care review is not done. It may mean there is no slot. It may mean the service asked for is not covered. It may also mean the person answered the screening questions in a way that did not show the real need.
Ask these questions before you give up:
- “Which program did you screen for?”
- “Was the denial based on Medicaid financial rules, level of care, safety at home, missing records, or no available waiver slot?”
- “Can I send new medical records or caregiver-loss proof?”
- “Is there a priority category, Home First review, emergency status, or risk-of-institutionalization review?”
- “Can you send the written notice and appeal rights?”
If the person’s care needs changed, ask for a new review. A recent fall, hospital stay, nursing facility stay, caregiver death, caregiver illness, or unsafe discharge plan can matter.
If denied or waitlisted
Ask for the decision in writing. The written notice should tell you what was denied, why, and how to appeal. Keep the envelope, the notice, and every page.
For Medicaid or waiver denials
Ohio uses the state hearing process for many Medicaid and waiver disputes. The Ohio Department of Job and Family Services Bureau of State Hearings has an online SHARE system. A person can ask for a state hearing if they believe benefits were wrongly denied, reduced, delayed, or stopped.
Do not wait if services are being reduced or stopped. The deadline and whether services can continue during the appeal may depend on the notice and timing.
For MyCare Ohio plan denials
If the decision came from a MyCare Ohio plan, follow the plan notice. Some issues go through the plan appeal process first. Some also have state hearing rights. The notice should explain the steps.
For waitlists
If the person is waitlisted, ask for the program name, date placed on the list, whether all eligibility steps are complete, and whether any priority or emergency review applies. Keep updating the agency when the person’s health or caregiver situation changes.
If care costs are unclear while you wait, use the care cost calculator. Also check other help routes, such as VA Aid and Attendance, caregiver tax deductions, local respite, and condition-specific programs.
Common problems that slow a case
- The person has not applied for Medicaid yet.
- The county office is waiting for bank, income, insurance, or identity papers.
- The medical record does not show the real daily-care need.
- The caregiver says “we manage” even when the person is unsafe without help.
- The person asks for a paid family caregiver but has not asked about the correct route.
- The wrong agency is called first.
- The person moved counties or changed plans, and the case did not transfer cleanly.
- Mail from Ohio Medicaid, the county office, the plan, or the case manager was missed.
Resumen en español
En Ohio, algunos programas de Medicaid pueden pagar servicios en el hogar si la persona cumple con las reglas médicas y financieras. Para una persona de 60 años o más, llame a la Agencia del Área sobre el Envejecimiento al 1-866-243-5678 y pregunte por PASSPORT. Para una persona menor de 60 años con discapacidad física, pregunte por Ohio Home Care Waiver.
Un familiar puede recibir pago en algunos casos, pero no siempre. Pregunte por self-direction, participant direction, y Structured Family Caregiving. Pida la decisión por escrito si niegan servicios o ponen a la persona en una lista de espera.
FAQ
Does Ohio Medicaid pay family caregivers?
Sometimes. Ohio may allow family payment through certain waiver services, self-direction, participant direction, or Structured Family Caregiving. The rules depend on the waiver and the family relationship. Ask the case manager or waiver service coordinator to check the exact rule.
Is PASSPORT only for seniors?
PASSPORT is for people age 60 or older who meet Medicaid and nursing facility level-of-care rules. People under 60 may need a different route, such as the Ohio Home Care Waiver, MyCare Ohio, a Developmental Disabilities waiver, or OhioRISE.
Can a spouse be paid?
Do not assume yes. Ohio rules limit when spouses and other legally responsible or decision-making relatives can be paid. Some routes may allow it only under strict conditions. Ask for the rule and the decision in writing.
What if my parent is over Medicaid income or asset limits?
Do not move money or give away assets without advice. Read Medicaid Spend Down and Medicaid Look-Back Period, then speak with a qualified Ohio elder law attorney or benefits counselor.
Can waiver services start right away?
Not always. The person may need Medicaid approval, a level-of-care assessment, a service plan, provider availability, and an open waiver slot. Ask what step is still missing.
Who should I call first?
For most people age 60 or older, call the Area Agency on Aging at 1-866-243-5678. For Medicaid application help, call Ohio Benefits at 1-844-640-OHIO (6446) or the Ohio Medicaid Consumer Hotline at 800-324-8680. For under age 60 physical-disability waiver questions, ask about the Ohio Home Care Waiver and ODM 02399.
About this guide
This guide was written for family caregivers who need a real starting point for Ohio Medicaid home and community-based waiver help. It focuses on home care, family caregiver payment questions, waitlists, applications, and appeals.
Disclaimer
This is general information, not legal, tax, medical, or financial advice. Rules can change. For legal or tax questions, talk with a qualified professional in your state.
Official sources used
- Ohio Department of Medicaid: Home- and Community-Based Services
- Ohio Department of Medicaid: Home- and Community-Based Services Nursing Facility Waivers
- Ohio Department of Medicaid: Ohio Home Care Waiver
- Ohio Department of Medicaid: ODM 02399 Request for Medicaid Home and Community-Based Services Waiver
- Ohio Department of Medicaid: Self-Direction Services and Information
- Ohio Department of Aging: PASSPORT
- Ohio Department of Aging: PASSPORT Eligibility
- Ohio Department of Aging: PASSPORT Participant Direction
- Ohio Department of Aging: Find a PASSPORT Administrative Agency or Area Agency on Aging
- Ohio Benefits: Contact Us
- Ohio Department of Medicaid: Contact Us
- Ohio Department of Job and Family Services: SHARE State Hearing System
- Ohio Administrative Code Rule 5160-31-03: PASSPORT eligibility and enrollment
- Ohio Administrative Code Rule 5160-31-05: PASSPORT covered services
- Ohio Administrative Code Rule 5160-46-02: Ohio Home Care Waiver eligibility and enrollment
- Ohio Administrative Code Rule 5160-46-06: Ohio Home Care Waiver covered services
- Ohio Administrative Code Rule 5160-58-02.2: MyCare Ohio Waiver eligibility and enrollment
- Ohio Administrative Code Rule 5160-58-04: MyCare Ohio Waiver covered services
- Ohio Administrative Code Rule 5160-44-32: provider and direct care worker relationships
- Ohio Administrative Code Rule 5160-44-33: Structured Family Caregiving
- Ohio Administrative Code Rule 173-44-04: unified waiting list
- Ohio Department of Developmental Disabilities: Waivers
- Ohio Medicaid: OhioRISE Waiver Overview for Children, Youth, and Caregivers
- Medicaid.gov: Ohio Waiver Factsheet
