Ohio Medicaid Eligibility 2026: Income Limits & Requirements

Ohio Medicaid eligibility 2026 income limits guide showing diverse family with state map, medical symbols, and new qualification requirements for children, adults, seniors, and pregnant women

Ohio Medicaid helps low-income residents get health coverage. This includes doctor visits, hospital care, prescriptions, and long-term care. Eligibility depends on your income, household size, age, and disability status.

Quick Summary:

  • Children up to 141% FPL qualify for Medicaid
  • Pregnant women covered up to 200% FPL
  • Adults 19-64 qualify up to 138% FPL
  • Seniors and disabled qualify up to 75% FPL
  • Work requirements start mid-2026 for some adults
  • Apply online at Benefits.Ohio.gov

Last Updated: January 15, 2026

Who Qualifies for Ohio Medicaid?

To qualify, you must meet these basic requirements:

  • Be a U.S. citizen or eligible non-citizen
  • Live in Ohio
  • Have or apply for a Social Security Number
  • Meet income limits for your category

Even if you’re unsure, apply anyway. The Ohio Department of Medicaid will check your eligibility.

2026 Ohio Medicaid Income Limits

Income limits change based on household size.

Here are the monthly income limits for 2026:

Income Limits Table

Household SizeChildren (0-18)Pregnant WomenParentsAdults (19-64)Seniors/Disabled
1$1,839$2,609$1,174$1,799$994
2$2,486$3,525$1,587$2,430$1,491
3$3,132$4,442$1,999$3,061$1,491
4$3,778$5,359$2,412$3,692
5$4,424$6,275$2,824$4,323
6$5,071$7,192$3,237$4,954
7$5,717$8,109$3,649$5,585
8$6,363$9,025$4,062$6,216

Note: Add $646 per extra person for children. Add $917 for pregnant women. Add $631 for adults 19-64.

These are gross monthly income amounts. Most categories use Modified Adjusted Gross Income (MAGI).

Source: Ohio Department of Medicaid

Eligibility by Group

Children (Ages 0-18)

Ohio covers children through Medicaid and CHIP (Healthy Families).

  • Medicaid: Up to 141% FPL
  • CHIP: 156% to 206% FPL
  • Infants (0-1): Up to 206% FPL
  • No asset test required

Pregnant Women

Coverage lasts through pregnancy plus 12 months postpartum.

  • Income limit: Up to 200% FPL
  • Count your unborn child in household size
  • No asset test required

Parents and Caretakers

Parents or relatives caring for children under 18.

  • Income limit: Up to 90% FPL
  • No asset test required

Adults Ages 19-64

Non-disabled adults without Medicare qualify.

  • Income limit: Up to 138% FPL
  • No asset test required
  • New: Work requirements start mid-2026

Seniors (65+) and Disabled

Called Aged, Blind, and Disabled (ABD) Medicaid.

  • Income limit: Up to 75% FPL
  • Asset limit: $2,000 single, $3,000 couple
  • Excludes home, one vehicle, burial funds

Working Disabled Adults

Medicaid for Workers with Disabilities (MWD) program.

  • Income limit: Up to 250% FPL
  • Pay monthly premiums
  • No asset limit

Asset Limits for Ohio Medicaid

Most people don’t have asset tests. This includes:

  • Children
  • Pregnant women
  • Parents
  • Expansion adults (19-64)

Asset tests apply to:

  • Seniors and disabled (ABD)
  • Nursing home care
  • Home and community-based services

Asset Limit Rules

Single applicant:

  • Assets must be $2,000 or less

Married couple (both applying):

  • Assets must be $3,000 or less

Married (one applying for long-term care):

  • Applicant: $2,000 or less
  • Spouse: $32,532 to $162,660 allowed

Exempt assets:

  • Your home
  • One vehicle
  • Burial funds up to $1,500
  • Personal belongings

Source: Ohio Department of Medicaid Long-Term Care

2026 Work Requirements (Important Update)

Starting mid-2026, some adults must meet work requirements.

Who Must Work?

Adults ages 19-64 in expansion Medicaid must:

  • Work 80 hours per month (20 hours per week)
  • OR do job training, education, or community service
  • OR participate in substance use treatment

Who Is Exempt?

You don’t need to meet work requirements if you are:

  • Age 55 or older
  • Parent of child under 14 or disabled child
  • Pregnant or postpartum (12 months)
  • Medically frail or disabled
  • Experiencing homelessness or domestic violence

Timeline

  • Requirements start: June-July 2026
  • Outreach begins: September 2026
  • Could be delayed to 2027-2029

This could affect 62,000 to 200,000+ people. Check with Ohio Medicaid for updates.


Long-Term Care Income Limits

If you need nursing home or waiver services:

Income limit: $2,982 per month (single)

Spousal protections:

  • Community spouse can keep income up to $4,066.50 monthly
  • Minimum spousal resource allowance: $32,532

Transfer penalty: $8,000 divisor for improper asset transfers

You must need nursing home level of care to qualify.

How to Apply for Ohio Medicaid

Online Application

  1. Visit Benefits.Ohio.gov
  2. Create an account
  3. Complete the application
  4. Upload required documents

Phone Application

Call 1-800-324-8680 for help applying.

In-Person Application

Visit your local County Job and Family Services office.

Documents You Need

  • Proof of income (pay stubs, tax returns)
  • Proof of Ohio residency
  • Social Security Number
  • Citizenship documents
  • Birth certificates for household members

Application Processing

  • Most applications process within 45 days
  • Disability cases may take up to 90 days
  • You’ll get a letter about your decision

Renewing Your Ohio Medicaid

Ohio Medicaid requires annual renewal.

Renewal process:

  1. Ohio Medicaid mails you a renewal notice
  2. Complete and return the form within 30 days
  3. Provide updated income and household information
  4. Keep your contact information current

Important: Don’t wait for the renewal notice. Update changes within 10 days:

  • Income changes
  • Address changes
  • Household size changes
  • Job changes

What Does Ohio Medicaid Cover?

Ohio Medicaid covers essential health services:

Medical services:

  • Doctor visits
  • Hospital care
  • Emergency services
  • Lab tests and X-rays
  • Mental health services
  • Substance use treatment

Prescription drugs:

  • Most medications covered
  • Some may need prior approval

Preventive care:

  • Wellness checkups
  • Immunizations
  • Cancer screenings
  • Dental (for children)
  • Vision (for children)

Long-term care:

  • Nursing home care
  • Home health services
  • Waiver programs
  • Adult day care

Next Generation MyCare Program

Starting January 1, 2026, Ohio launched Next Generation MyCare.

Who qualifies:

  • Age 21 or older
  • Have both Medicaid and Medicare
  • Live in participating counties

Benefits:

  • Coordinated care between programs
  • One care team
  • Better service coordination
  • Expanding statewide in 2026

This doesn’t include people on certain waivers or PACE.

If Your Application Is Denied

You have the right to appeal.

Appeal process:

  1. File appeal within 90 days of denial
  2. Request a state hearing
  3. Submit evidence supporting your case
  4. Attend your hearing

Call 1-800-324-8680 for help with appeals.

FAQs About Ohio Medicaid Eligibility 2026

1. What is the income limit for Ohio Medicaid in 2026?

Income limits vary by category. Children qualify up to $1,839 monthly for a household of one. Adults qualify up to $1,799 monthly. Pregnant women qualify up to $2,609 monthly. Check the table above for your household size.

2. Do I have to work to keep Ohio Medicaid in 2026?

Yes, if you’re age 19-64 in expansion Medicaid and not exempt. You must work or do qualifying activities 80 hours monthly starting mid-2026. Exemptions include parents of young children, pregnant women, and medically frail individuals.

3. Does Ohio Medicaid count my house as an asset?

No. Your primary home is exempt from asset limits. One vehicle and burial funds up to $1,500 are also exempt. Asset tests only apply to seniors, disabled, and long-term care applicants.

4. Can pregnant women get Ohio Medicaid if they work?

Yes. Pregnant women qualify with income up to 200% FPL ($2,609 monthly for one person). Your job doesn’t disqualify you if your income is below limits. Coverage continues 12 months after birth.

5. How long does Ohio Medicaid application take?

Most applications process within 45 days. Disability cases can take up to 90 days. You’ll receive a letter with the decision. Apply online at Benefits.Ohio.gov for fastest processing.

6. What happens if my income goes over the Ohio Medicaid limit?

You may lose coverage or qualify for a different category. Report income changes within 10 days. You might qualify for premium assistance or marketplace insurance. Don’t wait—update your case immediately to avoid gaps.

Get Help with Your Ohio Medicaid Application

Need assistance? Contact these resources:

Ohio Department of Medicaid:

Local County Job and Family Services:

  • Find your local office at Benefits.Ohio.gov

Legal Aid:

Source: Ohio Department of Medicaid, Centers for Medicare & Medicaid Services

Disclaimer: This article provides general information only. Eligibility rules may change. Always verify current requirements with the Ohio Department of Medicaid or your local office before applying.

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