Does Ohio Pay For In-Home Care?

Ohio’s state Medicaid program pays for certain in-home care services when prescribed by a health care provider as part of a care plan. Generally, Ohio’s Medicaid program doesn’t cover long-term home health services. Instead, it pays for temporary care to treat a condition or as part of a rehabilitation plan.

However, individuals with ongoing care needs may qualify for one of Ohio’s in-home care waivers or programs. These programs fund services for older adults and people with disabilities to help them remain living at home instead of moving into a care or nursing home.

The Ohio Home Care Waiver pays for nursing care and other services for eligible adults who would otherwise need to live in a residential nursing facility. Individuals 59 or younger who meet the eligibility criteria for Medicaid enrollment and can prove that they require a nursing facility level of care may qualify.

The waiver covers a broad range of medical, therapeutic and practical services. Examples of services covered by the Ohio Home Care Waiver include:

• Personal care services
• Home modifications
• In-home nursing care
• Therapeutic services to help you develop or maintain your functional abilities
• Meal deliveries
• Adult daycare
• Emergency alarm systems
• Case management services
• Transportation

The Ohio PASSPORT waiver is similar to the Home Care Waiver and covers adults aged 60 or older who are eligible for Medicaid. Individuals whose health care providers verify they can remain safely at home with the support of services covered by the program may qualify for the PASSPORT waiver. Medicaid pays the full cost of care for those whose income is below a specific threshold. Enrollees whose income exceeds this threshold may have to contribute a portion of the costs.

The PASSPORT waiver covers many of the same health, social and medical services as the Home Care waiver for qualified individuals. Enrollees can choose to direct their own care or have a case manager organize their care on their behalf. A state assessor will determine what assistance is necessary during a monthly face-to-face meeting.

The Ohio PACE program pays for in-home care services for Medicaid enrollees aged 55 and over. Alternatively, individuals can self-fund their PACE services. Seniors are eligible to receive PACE services if they require a level of care usually delivered in a nursing home setting. Currently, the Ohio PACE program is only available in the Cleveland area.

After enrolling in PACE, a multi-disciplinary team of health care professionals and social workers will work with eligible seniors to develop a care plan that enables them to live at home safely. Medicaid enrollees receive funding for any provisions prescribed by their PACE teams.