SEO METADATA — EDITOR REFERENCE

Title Tag: Ohio Medicaid & Estate Planning (2026): Look-Back, PASSPORT & Estate Recovery - ProbatePedia

Meta Description: Ohio Medicaid (ODM) covers nursing home and home care with a 60-month look-back. Ohio has expanded estate recovery — potentially reaching assets beyond the probate estate, including TOD deed property and some trust assets. A revocable trust does NOT protect from Ohio Medicaid during the owner's lifetime. Here's what Ohio elder law planning actually requires.

Ohio Medicaid & Estate Planning (2026)

Last Updated: March 2026 • Ohio Department of Medicaid (ODM)• OH Series — Article 7 of 8

| Content⚠ Verify Before Publication** | | --- | --- | | Governing agency | Ohio Department of Medicaid (ODM) | | Individual countable asset limit (nursing facility) | ~$2,000 (⚠ verify current ODM figure) | | Community Spouse Resource Allowance (CSRA) | Min ~$30,828; Max ~$154,140 (⚠ verify current federal CSRA amounts for 2026) | | Minimum Monthly Maintenance Needs Allowance (MMMNA) | ~$2,288/month minimum for community spouse (⚠ verify current federal minimum) | | Home equity limit | ~$730,000 (⚠ verify current ODM figure) | | Look-back period | 60 months from date of Medicaid application for nursing facility and HCBS waiver care | | PASSPORT waiver | Ohio's main HCBS waiver program; provides home care as alternative to nursing facility; same financial eligibility rules as nursing facility Medicaid | | Estate recovery statute | ORC §5162.21 — Ohio Medicaid estate recovery; ⚠ editor verify current scope — Ohio has historically had expanded recovery | | Estate recovery scope | ⚠ Must verify — Ohio has claimed recovery from: probate estate (confirmed); TOD deed property (⚠ verify current status); potentially trust assets (⚠ verify) |

Ohio Medicaid Countable vs. Exempt Assets

| ContentOhio Medicaid Countable?ContentNotes** | | --- | --- | --- | | Primary home | Exempt (conditional) | Exempt while: applicant intends to return; OR spouse lives there; OR dependent or disabled child lives there; subject to estate recovery after death | | One vehicle (any value) | Exempt | One vehicle | | Household goods and personal effects | Exempt | Reasonable amount | | Irrevocable prepaid burial up to $1,500 | Exempt (up to $1,500 — ⚠ verify current Ohio exempt burial amount) | Separate from funeral expenses | | Term life insurance (no cash value) | Exempt | No cash value = not countable | | Savings / checking / brokerage accounts | Countable | All liquid assets above individual limit | | IRA / retirement accounts (applicant) | Countable — if in pay status or voluntarily converted | Ohio Medicaid treatment of IRAs: if IRA is in payout status, distributions counted as income; principal may be countable — ⚠ editor verify current Ohio ODM IRA policy | | Revocable living trust | Countable — fully | Revocable trust DOES NOT protect from Medicaid eligibility; assets treated as applicant's own | | Irrevocable MAPT (funded > 60 months before application) | Generally exempt | Assets properly transferred to MAPT more than 5 years before application; strongest protection available | | Ohio TODD property (before death) | Countable — owner retains full ownership | TODD beneficiary has no current interest; property is applicant's asset for Medicaid purposes |

Ohio Estate Recovery and the TODD — A Critical Planning Issue

Ohio's Transfer on Death Deed is an excellent probate-avoidance tool. However, for Ohio residents who have received or may need Medicaid, the TODD may not provide protection from Ohio Medicaid estate recovery. This is one of the most significant Ohio-specific planning issues and must be verified with current Ohio ODM regulations.

| ContentProbate-Only Recovery StateContentOhio — Potential ImpactContentPlanning Implication** | | --- | --- | --- | --- | | Probate estate | Recovered | Recovered | Baseline — confirmed for all states | | TOD deed (TODD) | Protected (no probate) | ⚠ Ohio may assert recovery — ORC §5162.21 expanded recovery | Consult elder law attorney BEFORE using TODD if Medicaid is a concern | | Joint tenancy (JTWROS) | Protected | ⚠ Ohio may assert recovery from surviving joint owner | Same — verify with elder law attorney | | Irrevocable MAPT (properly funded, >60 months) | Generally protected | Generally protected | Most reliable protection against both eligibility and estate recovery | | Revocable living trust (at death) | Protected (no probate) | ⚠ Ohio expanded recovery may reach trust assets | Same — verify with Ohio elder law attorney |

For Ohio Residents Concerned About Medicaid — the MAPT is the Right Tool, Not the TODD:

For an Ohio homeowner who is worried about nursing home costs and wants to protect the family home, the Transfer on Death Deed is not the right primary tool — because Ohio's expanded estate recovery may allow ODM to recover from TODD property after the owner's death. The correct tool is an Irrevocable Medicaid Asset Protection Trust (MAPT), funded more than 5 years before the Medicaid application, which is generally recognized as the most durable protection against both Medicaid eligibility counts and estate recovery. The 5-year clock must start running as early as possible — ideally when the applicant is healthy, not in crisis. This is the core message of Ohio elder law planning.

Ohio MAPT — Key Features

• Must be irrevocable — Settlor cannot revoke or change beneficiaries after execution
• Settlor cannot be a discretionary beneficiary of principal — principal must pass to heirs at death
• Settlor may typically retain the right to income from MAPT assets
• Primary home may be placed in MAPT; Settlor retains a life estate to continue living there (or full use and occupancy)
• MAPT with retained life estate: the life estate value may still be subject to Ohio estate recovery — ⚠ verify with Ohio elder law attorney
• Assets transferred to MAPT more than 60 months before the Medicaid application are generally not penalized
• Assets transferred within 60 months: penalized; penalty period = transfer value ÷ Ohio average monthly nursing home cost (⚠ verify current Ohio divisor figure)
• MAPT combined with Ohio no-estate-tax: Ohio MAPT planning is simpler than in estate-tax states because there is no conflict between Medicaid planning and estate tax planning

Ohio MAPT + No Estate Tax = Cleaner Planning Than Most States:

In Massachusetts or Illinois, setting up a MAPT creates a tension: the MAPT removes assets from the taxable estate (good for estate tax) but also may trigger questions about whether the transferred assets are still includable in the estate for state estate tax purposes. In Ohio, this tension doesn't exist. Since Ohio has no estate tax, the only considerations for an Ohio MAPT are: (1) Does it protect from Medicaid eligibility? (2) Does it protect from Ohio estate recovery? The planning conversation is sharper and the strategies are cleaner.

Ohio Community Spouse Planning — Protecting the At-Home Spouse

| ContentOhio RuleContentNotes** | | --- | --- | --- | | Community Spouse Resource Allowance (CSRA) | Up to ~$154,140 (2026 — ⚠ verify); minimum ~$30,828 | Community spouse keeps the CSRA; assets above go toward Medicaid spend-down | | Primary home | Fully exempt while community spouse lives there | No home equity cap while spouse is living there | | MMMNA (monthly income allowance) | ~$2,288/month minimum (⚠ verify) | If community spouse's income is below MMMNA, share of institutionalized spouse's income allocated to community spouse | | CSRA snapshot | Taken at the first continuous period of institutionalization | Assets at that date used to calculate the CSRA | | Spousal impoverishment protections | Federal spousal impoverishment rules (42 U.S.C. §1396r-5) apply in Ohio | Ohio must follow federal minimums; may be more generous in some cases | | Annuity planning | Medicaid-compliant annuity can convert countable assets to income stream for community spouse; Ohio rules apply — ⚠ verify current Ohio ODM annuity treatment | Annuity must name Ohio as remainder beneficiary to extent of Medicaid paid |

✅ Verified Legal Data — March 2026

• ORC §5162.21 — Ohio Medicaid estate recovery statute — confirmed; ⚠ editor verify current expanded recovery scope

• Ohio Administrative Code §5160-12-04 through §5160-12-06 — Ohio estate recovery rules — ⚠ editor verify current version

• PASSPORT waiver: Ohio HCBS waiver program for home-based care — confirmed

• Individual asset limit: ~$2,000 — ⚠ verify current ODM figure

• CSRA: min ~$30,828 / max ~$154,140 — ⚠ verify current 2026 amounts

• Home equity limit: ~$730,000 — ⚠ verify current Ohio ODM figure

• 60-month look-back: federal requirement (42 U.S.C. §1396p) — confirmed

• Ohio MAPT: irrevocable trust protecting assets from Medicaid if funded >60 months before application — confirmed under federal principles

• Ohio expanded estate recovery for TODD property — ⚠ CRITICAL: editor must verify current status before publication

• No Ohio estate tax: no conflict between MAPT planning and estate tax planning in Ohio — confirmed

Ohio Series Navigation:

OH-1 → How to Avoid Probate in Ohio

OH-2 → Ohio Probate Process — Probate Court Step-by-Step

OH-3 → Ohio Small Estate & Summary Release from Administration

OH-4 → Ohio Transfer on Death Deed (TODD) — The Nation's Blueprint

OH-5 → Ohio Revocable Living Trust

OH-6 → Ohio Estate Planning: No Estate Tax, No Inheritance Tax

OH-7 → Ohio Medicaid & Estate Planning

OH-8 → Ohio Living Trust vs. Will

probatepedia.com · /ohio/estate-planning/medicaid/ · OH-7 of 8 · v1.0 March 2026