Understanding Medicaid & Long-Term Care Planning in Ohio

As you or a loved one age, the potential cost of long-term care becomes a serious concern. Many families worry about whether Medicaid can take their home if they require nursing home care. 

The reality is that Medicaid Estate Recovery can seek repayment after a Medicaid recipient’s death, but with proper planning, you can take steps to protect your home and assets.

This guide will help you understand Ohio’s Medicaid rules and explore strategies to protect your home, whether you’re planning ahead or facing an urgent Medicaid crisis.

Medicaid for the Aged, Blind, and Disabled in Ohio

Medicaid is a needs-based program that helps cover the cost of long-term care for seniors and individuals with disabilities. To qualify for Medicaid in Ohio, applicants must meet strict income and asset limits.

Basic Medicaid Eligibility Requirements (2025)

• Income Limits: Varies based on marital status and living arrangements. Generally, a single individual’s income must be below $2,901 per month subject to annual adjustments. For married couples who are applying, the income limit is $5,802 per month while the limit for married applicants who are applying alone is $2,901 per month as the non-applicant spouse’s income is not counted.
• Asset Limits: A single applicant or a married applicant applying alone may own no more than $2,000 in countable assets, while married applicants applying together may own no more than $3,000.

• Home Equity Limit: The home equity limit is $730,000.

• Exempt Assets: Medicaid does not count certain assets, including a primary residence (with equity up to $730,000 in 2025), one vehicle, household goods, and prepaid burial plans.

However, while your home may be exempt during your lifetime, Medicaid may attempt to recover its costs after your passing.

Medicaid Estate Recovery: Can Medicaid Take Your House?

Medicaid Estate Recovery is a federally mandated program that allows the state to recover long-term care costs from the estate of a deceased Medicaid recipient.

How Medicaid Estate Recovery Works in Ohio

• Medicaid can file a claim against the estate of a deceased recipient to recover costs paid for their care.
• The primary home is often the largest asset at risk, but there are exceptions.
• Recovery is typically pursued after both the recipient and their spouse have passed away.
• If certain heirs, like a disabled child, a caregiver child, or a spouse, are still living in the home, Medicaid may delay or waive recovery.

Without proper planning, your home could be subject to Medicaid’s estate recovery claim, forcing your heirs to sell it to repay Medicaid.

Pre-Planning for Medicaid & Long-Term Care

The best way to protect your home from Medicaid estate recovery is to plan ahead. Some of the most effective strategies include:

✅ Medicaid Asset Protection Trust (MAPT): Transfers ownership of your home to a trust at least five years before applying for Medicaid, shielding it from estate recovery.

✅ Life Estate Deeds: Allows you to retain the right to live in the home while legally transferring it to your heirs.

✅ Transfer-on-Death (TOD) Deeds: Enables your home to pass directly to heirs outside of probate. Beneficiaries of TOD deeds must complete and submit a “Notice to Medicaid Estate Recovery of Pending Transfer of Property by Transfer on Death Deed” (Form ODM 07408.)

✅ Spousal Protections: If one spouse enters a nursing home, the other spouse may keep the home without Medicaid recovery applying.

✅ Long-Term Care Insurance: Helps cover nursing home costs, reducing the need to rely on Medicaid.

Planning early is critical—many of these strategies require at least five years of lead time to avoid Medicaid’s look-back period.

How Can a Medicaid Asset Protection Trust (MAPT) Help?

A Medicaid Asset Protection Trust (MAPT) is one of the most powerful tools available to help safeguard your home and savings from Medicaid estate recovery. This type of irrevocable trust allows you to transfer ownership of your home and certain assets to the trust while still retaining the right to live in the home during your lifetime. Once five years have passed—outside of Medicaid’s look-back period—the assets in the trust are no longer considered available resources and are shielded from estate recovery.

Using a MAPT can help you qualify for Medicaid without being forced to spend down everything you’ve worked for. However, MAPTs must be carefully drafted and managed to comply with Medicaid rules. Working with an experienced elder law attorney ensures the trust is structured properly, so your assets are preserved for your heirs rather than lost to the state.

Crisis Planning for Medicaid: What If You Need Care Now?

If you or a loved one needs Medicaid immediately, it may still be possible to protect some assets through crisis planning. Even if you’re within the five-year look-back period, strategies exist to preserve as much as possible.

🔹 Spend Down Strategies: Legally reducing assets by purchasing exempt resources (such as home modifications, prepaid funeral expenses, or paying off debt).
🔹 Spousal Impoverishment Rules: Ensuring that the healthy spouse can retain sufficient assets.
🔹 Promissory Notes & Annuities: Converting excess assets into non-countable income streams.
🔹 Caregiver Agreements: Compensating family members for care provided to the Medicaid applicant.

Crisis planning requires expert guidance—applying the wrong strategy could lead to Medicaid penalties or unnecessary asset loss.

What Steps Should I Take Now to Protect My Home?

Whether you’re planning for the future or dealing with an urgent need for care, taking action now can protect your home and secure your legacy. Start by consulting with an estate planning and probate attorney who can help you understand your options under Ohio’s Medicaid rules. With professional guidance, you can evaluate your current assets, review your legal documents, and design a plan that aligns with your goals.

If you’re planning ahead, strategies like creating a Medicaid Asset Protection Trust, updating your estate plan, or securing long-term care insurance may offer additional protection. 

If you need care now, crisis planning strategies such as spend-downs, annuities, or caregiver agreements may still help preserve what matters. 

The earlier you act, the more flexibility you’ll have—and the greater your ability to protect your home.

Ohio Homeowners: Take Action to Protect Your Home & Assets

Medicaid rules are complex, and a misstep can cost your family their home or savings. The right legal strategies can help preserve your assets, protect your loved ones, and ensure you receive the care you need.

At Ohio Heritage Law, we specialize in Medicaid planning, asset protection, and elder law. Whether you’re planning ahead or in a crisis, we can help you navigate the system and protect what matters most.

📞 Call us at (330) 571-4151
📩 Schedule a consultation

Planning now can save your home and legacy later. Don’t wait—get expert guidance today! ⚖️🏡

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