Ohio Long-Term Care Planning

Transfers need timing and documentation

Ohio reviews uncompensated transfers during a 60-month look-back for institutional and HCBS-waiver Medicaid cases using the Special Income Level. The confirmed transfer-penalty divisor is $7,787 per month, effective September 1, 2024, under ODM MEPL No. 181 (OAC 5160:1-6-06; ODM MEPL No. 181).

Ohio recognizes stated exemptions and an undue-hardship process, but the facts, records, and applicable category matter. A transfer should not be assumed exempt simply because it was made to a relative (OAC 5160:1-6-06; OAC 5160:1-6-06.6).

Home planning and estate recovery are connected

Ohio's Transfer on Death Designation Affidavit can pass real property outside probate, but Ohio has expanded estate recovery and a recorder disclosure process for TOD beneficiaries. The affidavit can be useful for title and probate planning without being an automatic Medicaid-recovery solution (Ohio Revised Code § 5302.221; Ohio Revised Code § 5162.21).

Ohio's estate-recovery statute also contains protections for a surviving spouse, specified children, and qualifying home-resident siblings or caregiver children. The rule is fact-specific and requires attention to residence and documentation conditions (Ohio Revised Code § 5162.21).

Partnership insurance is another Ohio-specific lever

A qualifying Ohio Long-Term Care Partnership policy disregards assets dollar for dollar up to benefits paid, both at Medicaid eligibility determination and estate recovery. The rules are distinct from general trust planning, and only qualifying policies receive this treatment (OAC 5160:1-6-02.2).

Compare Florida's long-term-care planning page for another income-cap state's approach. For advance-planning context, visit Advance Medicaid Planning.