Ohio Medicaid provides health coverage for people with low income, including children, pregnant individuals, families, working adults, seniors, and people with disabilities. Coverage includes doctor visits, hospital care, prescriptions, preventive services, and long-term care support for those who qualify.
Ohio expanded Medicaid in 2014, allowing more adults to qualify based on income alone. In 2026, that expansion remains in place, but important policy updates and managed care changes make it essential to understand the current rules before applying. Applying with accurate information helps avoid delays or denials.
This guide explains eligibility groups, income limits, household size rules, asset limits, and how to apply for Ohio Medicaid in 2026.
Understanding Medicaid in Ohio for 2026
Ohio Medicaid is administered by the Ohio Department of Medicaid and operates under federal guidelines with state-specific rules. While benefits remain broad, enrollment and plan options can vary by county and eligibility group.
Medicaid covers primary care, hospital services, prescriptions, mental health care, and preventive services. Children receive dental and vision coverage, while adults receive emergency dental care. Long-term care services are available for those who meet medical and financial requirements.
Critical 2026 Policy Update: Next Generation MyCare
As of January 1, 2026, Ohio launched the Next Generation MyCare program in 29 counties, with a statewide rollout planned to follow. This change directly affects dual-eligible individuals (people enrolled in both Medicare and Medicaid).
Under this update:
- New managed care plans replaced previous options in participating counties
- Available plans are:
- Anthem Blue Cross and Blue Shield
- CareSource
- Molina Healthcare
- Buckeye Health Plan is no longer available for new MyCare enrollees
Newly eligible dual-eligible members must select one of the three approved plans. Existing members may be transitioned automatically but should review plan notices carefully.
Who Qualifies for Medicaid in Ohio in 2026?
Anyone may apply for Ohio Medicaid, but approval depends on income, household size, age, disability status, and pregnancy.
Eligibility groups include:
- Adults ages 19–64 under Medicaid expansion (no disability or children required)
- Children and teens up to age 18 through Healthy Start (CHIP)
- Pregnant individuals with extended postpartum coverage
- Parents or caretakers of dependent children
- Seniors age 65 and older
- Individuals with disabilities
Applicants must be Ohio residents and U.S. citizens or qualified non-citizens.
Ohio Medicaid Income Limits by Eligibility Group (2026)
Income limits vary by group. While updated Federal Poverty Level (FPL) figures typically release in January, Ohio usually applies new income thresholds in March or April.
Income Limits by Group
| Group | Income Limit (% FPL) | Key Detail |
|---|---|---|
| Children (0–18) | Up to 206% | Covered under Healthy Start (CHIP) |
| Pregnant Women | Up to 200% | Coverage lasts through pregnancy + 12 months postpartum |
| Adults (19–64) | Up to 138% | Medicaid expansion group |
Important: If your income is slightly above the 2025 limit, applying in early 2026 is still recommended. The annual FPL adjustment may make you eligible once updated limits are applied.
Ohio Medicaid Income Limits (2025 Figures Used Until 2026 Update)
Until Ohio publishes official 2026 numbers, the confirmed 2025 income limits remain in effect for adult expansion eligibility.
| Household Size | Maximum Annual Income (2025) |
|---|---|
| 1 | $20,120 |
| 2 | $27,214 |
| 3 | $34,307 |
| 4 | $41,400 |
| 5 | $48,493 |
| 6 | $55,586 |
| 7 | $62,679 |
| 8 | $69,772 |
Children, pregnant individuals, seniors, and people with disabilities follow different income rules and may qualify at higher levels.
How Household Size Impacts Medicaid Eligibility in Ohio
Household size includes the applicant, spouse, and tax dependents. For some groups, Ohio uses tax-filing relationships to determine household size.
Larger households qualify at higher income levels. Counting household members accurately is essential, as errors can lead to denial or delays.
Can You Get Medicaid in Ohio If You Are Working?
Yes. Employment does not disqualify you from Ohio Medicaid. Many working adults qualify under Medicaid expansion, including part-time workers, gig workers, and those with fluctuating income.
Income is evaluated monthly and averaged when necessary.
Does Ohio Medicaid Have Asset Limits?
Asset rules depend on the eligibility group.
- No asset limits for adults under 65 in the expansion group
- No asset limits for children or pregnant individuals
- Asset limits apply to seniors (65+) and individuals applying under disability or long-term care categories
Asset Limit for Seniors and Disabled Applicants
- Individual limit: $2,000
- Couple limit: $3,000
Exempt assets typically include:
- One primary residence (if living in it)
- One vehicle
- Personal belongings
Ohio Medicaid Long-Term Care Eligibility (2026)
Long-term care Medicaid helps cover nursing home care or home- and community-based services for individuals who need assistance with daily activities.
Eligibility requires:
- Meeting income and asset limits
- Demonstrating medical need for long-term care
Ohio may revise long-term care financial thresholds during 2026, so applicants should verify current limits when applying.
How to Apply for Medicaid in Ohio
You can apply:
- Online at benefits.ohio.gov
- In person at your county Job and Family Services office
- By mail or fax using forms from medicaid.ohio.gov
Required documents typically include proof of identity, income, residency, and household information.
How Long Does Ohio Medicaid Approval Take?
Most applications are processed within 45 days. Disability-based or long-term care applications can take up to 90 days. Missing documents are the most common cause of delays.
Pro Tips for Ohio Medicaid Applicants in 2026
Retroactive Coverage: Ohio Medicaid offers up to three months of retroactive coverage. If you had unpaid medical bills in the three months before applying, Medicaid may cover them if you were eligible during that time.
Estate Recovery Warning (Age 55+): Ohio is required to pursue Medicaid Estate Recovery for long-term care costs after a recipient’s death. This can affect assets passed to heirs and should be considered in long-term planning.
Income Updates Timing: Even though policy changes take effect January 1, updated income limits are often applied in March or April. Apply early even if you think your income may be slightly over the current limit.
Ohio Medicaid vs Marketplace Insurance in 2026
Medicaid generally has no premiums and minimal out-of-pocket costs. Marketplace plans may offer subsidies for higher incomes but usually include premiums, deductibles, and copays.
If you are denied Medicaid due to income, healthcare.gov is the next step.
Key Takeaways
Ohio Medicaid remains a critical safety net in 2026. Expansion continues to cover low-income adults, while children and pregnant individuals qualify at much higher income levels. Seniors and disabled applicants must meet strict asset rules, and new managed care changes under Next Generation MyCare affect dual-eligible members. Applying early and accurately is the best way to secure coverage.
Ohio Medicaid Eligibility 2026; FAQs
Who qualifies for Medicaid in Ohio in 2026?
Adults 19 to 64 with low income, children, pregnant people, parents, seniors, and disabled qualify. Expansion helps adults without kids if income fits.
What is the income limit for Medicaid in Ohio in 2026?
Limits vary by group and size. Ohio updates them in January 2026, so check benefits.ohio.gov for your case.
Does Ohio Medicaid count household size?
Yes, size includes everyone living together. It raises income limits for bigger families.
Can a working adult qualify for Medicaid in Ohio?
Yes, many do if income is low. Expansion covers part-time or low-wage workers.
Are Ohio Medicaid income limits changing in January 2026?
Yes, updates happen then. Some limits may rise with costs.
