Ohio’s Medicaid PASSPORT Waiver

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

The Ohio Medicaid PASSPORT waiver program allows seniors that require a nursing facility level of care to remain living at home, or the home of a family member, and receive care in those locations. Seniors are able to live a higher quality of life, as this program provides them with care services and other benefits to promote independence. In addition, the state of Ohio saves money by leveraging the caregiving provided by friends, spouses, and family members. Unfortunately, the state caps the amount of money spent on a senior in the program each month. 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 include 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 and medical appointments.

 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 who provides them with care services. Friends and certain family members, excluding one’s spouse, can provide non-skilled care services, such as personal care. Most relevant, the adult children of elders are able to provide care. However, Medicaid only pays a standard rate between $10 and $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.

***Persons who are dually eligible for Medicaid and Medicare, and live in a county where the Integrated Care Delivery System (ICDS), also referred to as MyCare Ohio, is available, are not eligible for the PASSPORT waiver. Rather, one can receive all of the same services via MyCare Ohio, a mandatory managed care program. Learn more here.

 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. (Individuals between the ages of 60 and 64 must be physically disabled). In addition, all applicants are assessed to determine if they require the level of care found in nursing homes, this typically means they need significant assistance with the Activities of Daily Living. Persons with dementia or Alzheimer's do not automatically qualify, although their care needs are assessed under special procedures.

The financial guidelines for the PASSPORT Waiver are the same as Ohio Institutional (nursing home) Medicaid limits. An individual's gross monthly income must be less than three times the Federal Benefit Rate, which as of 2018, is $2,250. When the applicant is married and their wife or husband does not need care, then only income in the name of the applicant is counted towards the income limit. In addition, in some cases, the applicant spouse is also able to allocate some of their monthly income to the non-applicant (community) spouse. This is called the Monthly Maintenance Needs Allowance. It is intended to prevent the community spouse from having too little income in which to adequately live. 

The total value of an individual’s countable assets cannot exceed $2,000. However, one's home is not included as a countable asset provided the owner, or their spouse, lives in the home and the value of their real estate does not exceed $572,000. Another exception to the $2,000 limit is when the individual is married and their spouse is not seeking benefits under Medicaid. In this situation, the non-applicant spouse can have up to $123,600 in joint countable assets. This is called the Community Spouse Resource Allowance.

It is possible for persons with income or assets greater than 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 Medicaid exempt annuities, burial plans, and other non-countable resources. Learn more about this option

Persons ineligible for PASSPORT might be able to receive services under Ohio's Older American Act

 

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
  • Community Transition Services
  • Disposable Medical Supplies
  • Durable Medical Equipment
  • Home Delivered Prepared Meals and Nutritional Counseling
  • Home Modifications
  • Homemaker Assistance (such as Laundry or Housekeeping)
  • Personal Care
  • Personal Emergency Response Service
  • Pest Control
  • Respite Care (Out-of-Home)
  • Social Work Counseling
  • Transportation (Medical Appointments and Non-Medical)

 

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 run out of slots for qualified persons. Applicants placed on a waiting list will have to wait for a space to open when someone leaves the program. 

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 may also want to consider the Ohio Medicaid supported Assisted Living Waiver