Ohio’s Medicaid PASSPORT Waiver

Page Reviewed / Updated - Apr. 2015

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers," which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.

Waiver Description

This Ohio Medicaid waiver program allows seniors that require a nursing facility level of care to remain living at home or in the community and receive care in those locations. This program is intended to provide seniors with a higher quality of life by providing them a choice of residential locations in which they can receive care services. It is also intended to save the state of Ohio money by leveraging the caregiving provided by friends, spouses and family members. Therefore, the cost of care provided at home cannot exceed 60% of the cost for that same care, if it were provided in a nursing home.

The types of care paid for under PASSPORT includes personal care, both at home and in adult day care settings, independent living support such as home delivered meals, laundry, housekeeping etc.  Also, covered are medical equipment, disposable supplies and transportation assistance for doctors visits.

 Under PASSPORT, family members can be hired to provide personal care.

The PASSPORT Program now permits consumer direction of services.  This allows the beneficiary to have a degree of control over whom provides them with care services.  Non-skilled care services such as personal care can be provided by friends and certain family members, most relevantly the adult children of the elder.  However, one should note that Medicaid only pays a standard rate between $10 - $14 per hour for their caregiving.

PASSPORT is an acronym for Pre-Admission Screening System Providing Options & Resources Today.  This program is under the administration of the Ohio Department of Aging and is managed locally by the Area Agencies on Aging.

 Did You Know? Ohio residents can receive free quotes for bathroom modifications such as the addition of a walk-in tub to help them remain living safely in their homes. Learn more.

 

Eligibility Guidelines

In addition to being an Ohio resident and aged 60 or older, this waiver has both disability requirements and financial restrictions. Applicants are assessed to determine if they require the level of care found in nursing homes, this typically means they are in need of significant assistance with the activities of daily living.  Persons with dementia or Alzheimer's do not automatically qualify, although their particular care needs are assessed under special procedures.

The financial guidelines for the PASSPORT Waiver are the same as Ohio Institutional Medicaid limits. In 2015, an individual's gross monthly income must be less than $2,199.

The total value of their countable assets cannot exceed $1,500. However, one's home is not included as a countable asset provided the owner lives in the home and the value of their real estate does not exceed $552,000. Another exception to the $1,500 limit is when the individual is married and their spouse is not seeking benefits under Medicaid. In this situation, the spouse can have up to $119,220 in countable assets. This is called the Community Spouse Resource Allowance.

 Important* It is possible for persons with income or assets in excess of these limits to qualify for the PASSPORT waiver. By getting Medicaid planning help, applicants can re-allocate income into a pooled trust and assets into exempt annuities, burial plans and other non-countable resources.  Learn more about this option.

 

Benefits and Services

Each applicant is screened to determine their eligibility and for which services they might be eligible.  The case manager and the participant work out the details of the care plan together. Possible services include the following.  Certain, unskilled services are available for self-direction.

  • Adult Day Care
  • Chore Services
  • Disposable Medical Supplies
  • Durable Medical Equipment
  • Home Delivered Prepared Meals and Nutritional Counseling
  • Homemaker Assistance (such as Laundry or Housekeeping)
  • Personal Care
  • Personal Emergency Response Service
  • Transportation Assistance for Medical Appointments

 

How to Apply / Learn More

While this program is available statewide across Ohio, there is a cap on the number of available participants.  Approximately 35,000 individuals are provided services simultaneously.  However, even at that capacity, the state may put qualified persons on an interest list in order to wait for available slots to open up. 

Ohio residents should contact their local area agency on aging to apply or call 1-866-243-5678. The program webpage provides additional details about this waiver.

Ohio residents should also consider the Assisted Living Waiver