Page Reviewed / Updated - May 2019
This webpage will help Ohio residents understand assisted living, home care, and adult day care costs throughout the state. It also explores the payment options and financial assistance programs available to assist in caring for the elderly, be that in residential care or for aging in place at home.
While, the programs outlined here are comprehensive of what is available from the state of Ohio, it is not comprehensive of what is available at a national level. In order to find the program that is most suitable for the situation, it is very important to consider all options. To easily search for assistance nationwide, please use our Resource Locator Tool.
Across Ohio, in 2019, the average cost of assisted living is $4,278 / month. This cost per month is just over the average cost of assisted living nationwide, which is $4,000 / month. However, certain areas of Ohio average even higher monthly costs, which include Akron, Mansfield, Dayton, and the Cincinnati-Middletown-Wilmington area. Residents in these areas should expect to pay an additional $252 - $1,022 / month for assisted living care. The least expensive areas of Ohio in which to receive care are Springfield, Youngstown, Cleveland, and Canton. Care recipients in these areas can expect to pay between $479 - $1,185 less each month than the national average for assisted living care.
Alzheimer's care (in assisted living residences) has traditionally been more expensive, and Ohio is no exception. The additional monthly fee for residents who are suffering from Alzheimer's is approximately $1,283, due to the need for an increased level of care and security. It is worth noting that this figure can vary widely depending on the stage of the disease. Individuals in the early stages may experience zero additional costs, as they might not yet need additional care and security.
In 2019, the hourly average rate for non-Medical home care (sometimes called homemaker services) is $21.00. This is just slightly up from 2018. Hourly fees in the most and least expensive areas of Ohio only vary by approximately ten percent. The urban centers of Columbus, Cincinnati, Cleveland, Toledo, and Dayton being the most expensive ($21.00 - $23.00 / hour), and the rural areas around Mansfield, Youngstown, Canton, and Akron are the least costly ($19.00 - $20.00 / hour).
Home health care is also available for individuals who require minimal medical care. On average, this type of care costs approximately $1.50 more per hour than home care.
Adult day care is also relevant to elderly individuals living at home. With a statewide average of $61 / day in 2019, this is one of the most affordable ways to receive eldercare services. Contrary to assisted living where the state average is just above the national average, adult day care in Ohio is well below the national average of $72 / day. Adult day care is even less expensive in the areas of Canton, Toledo, Springfield, and Mansfield, where it can be found for as little as $58 / day. In Columbus and Cincinnati, the cost is closer to $72 / day.
Medicaid Program Explanation
Medicaid can be somewhat confusing, as the name is used to describe a variety of programs. At the top level, Medicaid is an insurance program for low-income Americans that is co-managed by the U.S. Government and each state government. Relevant to this webpage is "institutional" or "long-term care Medicaid," which is intended for elderly and / or disabled individuals. Qualified residents can receive care in nursing homes or receive "waivers," which allow them to receive care outside of nursing homes.
Medicaid Eligibility in Ohio
Medicaid evaluates applicants' financial holdings, including their monthly income and total countable resources. In 2019, the monthly income of a single applicant for long-term care Medicaid or waivers cannot be greater than $2,313 / month. This amount is equivalent to 300% of the Federal Benefit Rate (FBR). For a single applicant, the countable resource limit in Ohio is $2,000, though one's home, limited to an equity value of $585,000, a vehicle, and other personal objects are exempt from this limit.
This is an over-simplification of Medicaid's limits. Married individuals have different and less restrictive requirements, and eligibility requirements may vary slightly based on the Medicaid program in which one is applying. In addition, even individuals exceeding these limits can still qualify. For example, if one is applying for a Medicaid waiver and is over the income limit, one may utilize a Qualified Income Trust (QIT), also called a Miller Trust. In simple terms, a QIT is an irrevocable trust in which income over the limit is deposited, and a trustee is named. The trustee is then responsible for using the money for very specific purposes, such as payments towards long-term care.
Also, if only one spouse of a married couple is applying for institutional care or a Medicaid waiver, a portion of the applicant’s income can be allocated to the non-applicant (community) spouse. This is called the monthly maintenance needs allowance and allows up to $3,160.50 / month of the applicant’s income to be transferred to the non-applicant spouse. There is also a community spouse resource allowance in place that allows a non-applicant spouse to retain up to $126,420 of the couple’s joint assets. This prevents the community spouse from becoming impoverished and also effectively lowers the applicant spouse’s countable income and assets.
Free assistance is available to help one determine their Medicaid eligibility and also to help with the preparation of paperwork. If a family is uncertain about their loved one's eligibility, or if an applicant is over the income and / or asset limit(s), it is recommended they contact a Medicaid expert.
Waivers and Programs
There are three relevant Medicaid waivers and programs, also referred to as Home and Community Based Services Waivers, available in Ohio that offer assistance to the elderly. It’s important to note, waivers are not entitlement programs, which means all eligible applicants may not be able to receive services. There are a certain number of available participant slots, and once those slots are filled, there is a wait list for assistance.
The PASSPORT Waiver helps residents who might otherwise require nursing home care by providing a suite of home-based care services. Benefits may include personal care assistance, adult day care, meal delivery, and durable medical equipment. This waiver allows for self-direction, meaning individuals can choose their caregiver, including select family members.
The Assisted Living Waiver helps pay for the cost of certain services in assisted living at participating assisted living communities. Services may include skilled nursing, medication assistance, housekeeping, and personal care. It is worth mentioning, this waiver does not cover the room and board portion of the fees.
Finally, a new managed Medicaid program is available in 29 counties throughout the state. This program is called the MyCare Ohio Plan (MCOP). This program is for dually eligible Medicaid and Medicare individuals, and allows a single point of contact for services from both programs.
It should be mentioned that a program called Choices Home Care Waiver, which many residents may have heard of, is no longer available as of 2014.
Ohio, unfortunately offers few programs that provide direct, non-Medicaid, financial assistance for care as many other states do. However, there is one such program worth mentioning.
The Ohio Elderly Services Program (ESP) provides in-home personal care and homemaker services. Other benefits include medical transportation, durable medical equipment, personal emergency response systems, adult day care, meal delivery, and respite care.
There is also a Residential State Supplement (RSS) program, which is provided by the Ohio Department of Mental Health. RSS provides financial assistance towards the cost of adult group homes, adult foster care, and assisted living. Personal care assistance, medication monitoring, and recreational activities may also be provided in the residential setting. In order to be eligible, one must be enrolled in Medicaid.
The state also offers several programs intended to help low-income, elderly residents to remain living in their homes. Some programs provide in-home assistance, while other programs reduce the recipients overall living expenses, which then frees up dollars that can be applied towards care services.
The Golden Buckeye program helps residents save money on many services they receive, most notably prescription drugs. More information on this program is available on the Ohio Department of Aging website. Another option for reducing one's expenses is to receive assistance for home heating and cooling costs. More information is available about these programs here and here. Finally, some in-home, non-care, assistance services may be available locally from one of the state's Area Agencies on Aging. Additional information about services for seniors under the Older Americans Act can be found here.
In addition to the state specific options that help pay for care, there are many non-profit and federal options. Use our Resource Locator Tool to find other programs that help pay for or reduce the cost of care. There are also programs that help veterans with assisted living and there are eldercare loans available in Ohio.
The two best strategies for affording the cost of care are 1) only opting for the care a loved one needs and 2) find a high-quality, affordable care provider. To help families make these strategies a reality, we have developed partnerships with several organizations who will, at no charge, help to assess an individual's care requirements and match them with the most affordable care provider in their geographic areas. Click here to find affordable care.
For more information about the costs and resources available in Ohio cities, click on the links below.