Ohio Medicaid Income Limits (2026)

Ohio Medicaid covers more than 3 million Ohioans in 2026, making it one of the largest public health programs in the state. Because Ohio adopted the Affordable Care Act Medicaid expansion in January 2014, adults ages 19 to 64 qualify based solely on income, without needing to have dependent children, a disability, or pregnancy. The 2026 income threshold for this adult expansion group is 138% of the Federal Poverty Level, which works out to $22,025 annually for a single person or $45,540 for a family of four, based on the 2026 HHS poverty guidelines published by the U.S. Department of Health and Human Services (aspe.hhs.gov). Ohio Medicaid is administered by the Ohio Department of Medicaid (ODM), with day-to-day eligibility work handled by county Departments of Job and Family Services across the state's 88 counties.

Ohio Medicaid eligibility splits across four main population groups with different income thresholds. Adults ages 19 to 64 (the ACA expansion group) qualify at 138% FPL. Children through age 18 qualify under the Healthy Start program at 211% FPL, a significantly more generous threshold that allows many working-class families to cover their children even when parents earn too much for adult Medicaid. Pregnant women qualify at 205% FPL, which counts the unborn child as a separate household member for income calculations. Elderly and disabled Ohioans who need long-term care face a separate means-tested track, with a $2,982 per month income cap and a $2,000 asset limit for single applicants in 2026. Each group applies through the same Ohio Benefits portal at benefits.ohio.gov, though the eligibility determination process may differ. All MAGI-based groups (adults, children, pregnant women) do not face an asset test.

Ohio Medicaid uses MAGI (Modified Adjusted Gross Income) rules for the adult, children, and pregnancy groups. Under MAGI, income is counted the same way as on a federal income tax return, meaning most wages, self-employment income, Social Security benefits (taxable portion), and investment income count toward eligibility. Supplemental Security Income (SSI), child support received, workers' compensation, and VA disability payments do not count. Ohio also applies the federal 5% income disregard for MAGI groups, effectively raising the practical income ceiling above the nominal 138% FPL floor for adults. Starting January 2026, Ohio launched the Next Generation MyCare program in 29 counties, a new integrated care model for Ohioans who qualify for both Medicare and Medicaid (dual-eligibles). Details on MyCare enrollment are available at medicaid.ohio.gov.

Ohio Medicaid income limits by household size (2026)

Ohio Medicaid income limits by household size (2026). Adult column = ACA expansion group (138% FPL, ages 19-64). Children column = Healthy Start (211% FPL, ages 0-18). Pregnancy column = 205% FPL (unborn child counted as household member). All figures based on 2026 Federal Poverty Level guidelines for the 48 contiguous states.

Ohio Medicaid eligibility requirements (non-income)

Ohio Medicaid eligibility depends on income, residency, citizenship or immigration status, and the specific population group an applicant falls into. Income is the primary gate for most groups. Non-income requirements apply to all applicants regardless of income level.

• Ohio residency: applicants must live in Ohio with the intent to remain. There is no minimum length-of-residency requirement. Homeless applicants may use a shelter address or county agency address.
• U.S. citizenship or qualifying immigration status: U.S. citizens and most lawful permanent residents qualify. Undocumented immigrants generally do not qualify for full Ohio Medicaid, though emergency Medicaid covers acute care regardless of status. Refugees and certain humanitarian parolees may qualify immediately; most other lawful immigrants face a 5-year waiting period.
• Social Security Number: each household member applying for coverage must provide a Social Security Number or proof they have applied for one. Members not applying (such as an undocumented parent applying only on behalf of a U.S.-citizen child) do not need to disclose their own SSN.
• Age and population-group requirements: the ACA expansion group covers adults ages 19 to 64. Children ages 0 to 18 qualify under Healthy Start. Pregnant individuals qualify through the pregnancy group at any age. Adults 65 and older qualify under the aged Medicaid track (asset-tested). Disabled individuals under 65 qualify under SSI-related rules (asset-tested).
• Asset test: MAGI-based groups (adults 19-64, children, pregnant women) face NO asset test. Only the aged, blind, and disabled (ABD) and long-term care categories are asset-tested. For single ABD applicants, countable assets must be under $2,000; for couples, under $3,000. The family home, one vehicle, and certain retirement accounts are typically exempt.
• Other coverage: Ohioans enrolled in Medicare (Part A or Part B) may still qualify for Medicaid to cover cost-sharing, long-term care, or services Medicare does not cover. Having employer-sponsored insurance does not automatically disqualify an applicant, though Ohio Medicaid may coordinate benefits with other coverage.

What income counts for Ohio Medicaid

Ohio Medicaid uses MAGI (Modified Adjusted Gross Income) rules for the adult expansion group, children, and pregnant women. MAGI income is calculated the same way as federal adjusted gross income for tax purposes, with one key addition: tax-exempt Social Security benefits are also counted. Ohio applies the federal 5% income disregard on top of the MAGI calculation, which effectively raises the practical eligibility ceiling slightly above the nominal 138% FPL floor for adult expansion enrollees. For the aged, blind, and disabled categories, a different non-MAGI income standard applies, counting nearly all income received including SSI.

Income sources included

• Wages, salaries, and tips (W-2 income) for every working household member
• Net self-employment income (gross receipts minus allowable business expenses, as reported on Schedule C or Schedule SE)
• Social Security retirement and survivor benefits (the full gross amount before Medicare premium deductions, not just the taxable portion)
• Social Security Disability Insurance (SSDI) benefits (full gross amount)
• Interest, dividends, and capital gains distributions
• Unemployment compensation benefits
• Pension and annuity distributions, and retirement account withdrawals (401(k), IRA, 403(b))
• Rental income (net of allowable deductions for mortgage interest, taxes, and depreciation on the rental property)
• Alimony received under divorce or separation agreements finalized before January 1, 2019 (pre-TCJA agreements only; post-2018 alimony is not taxable income and therefore not counted)

Income sources excluded

• Supplemental Security Income (SSI) payments: SSI is a needs-based federal cash benefit, distinct from SSDI, and is excluded from MAGI income counting
• Child support payments received (excluded from the recipient's income under MAGI rules)
• Veterans Affairs (VA) disability compensation, VA pension benefits, and GI Bill education payments
• Workers' compensation benefits (excluded from MAGI income)
• TANF (Temporary Assistance for Needy Families) cash assistance payments
• Gifts, inheritances, and lottery winnings (one-time windfalls do not count as MAGI income for ongoing Medicaid eligibility, though a very large windfall may prompt a redetermination review)
• Foster care payments received for caring for a foster child

How to apply for Ohio Medicaid in Ohio

Ohio Medicaid applications are processed through Ohio Benefits, the state's integrated online benefits portal at benefits.ohio.gov, which is operated by the Ohio Department of Medicaid in coordination with county Departments of Job and Family Services. The same application covers Medicaid, CHIP (Healthy Start), SNAP, Ohio Works First (cash assistance), and child care assistance. Applicants can apply online at any time, by phone at 1-800-324-8680, by mail, or in person at their local county DJFS office. Ohio processes standard Medicaid applications within 45 days and pregnancy applications within 15 days under federal expedited-processing rules.

1. 1. Gather your documents before starting: photo ID or proof of identity for the head of household, Social Security Numbers or proof of application for all household members, proof of Ohio residency (utility bill, lease agreement, or mortgage statement), proof of income for the past 30 days (pay stubs, employer letter, or self-employment records), and proof of citizenship or qualifying immigration status (birth certificate, passport, or permanent-resident card).
2. 2. Create an account or log in at benefits.ohio.gov. Select 'Apply for Benefits' and choose Medicaid. The application walks through household composition, income, and expenses step by step. You can save and return if you need to gather more information.
3. 3. Complete the household and income sections. List every person living in the household, all sources of income, and any income excluded under MAGI rules (such as SSI, child support, or VA benefits). The portal will prompt you to upload or mail supporting documents.
4. 4. Submit the application electronically and save or print the confirmation number. Your county DJFS office will receive the application and may contact you for additional information within the 10-day window. Respond promptly; failure to provide requested information is the most common reason Ohio Medicaid applications are denied.
5. 5. Respond to any request for additional information from your county DJFS within the timeframe specified (typically 10 days). You can upload documents directly through your Ohio Benefits account, fax them, or bring them in person to your county office.
6. 6. Wait for the eligibility determination notice. Ohio sends written notices by mail and through your Ohio Benefits online account. If approved, your Medicaid card and managed care plan selection information will follow. If denied, the notice will explain the reason and your right to appeal within 90 days.

Official portal: benefits.ohio.gov

Documents needed

• Photo ID for the head of household (Ohio driver's license, state ID, passport, or other government-issued photo identification)
• Social Security Numbers for every household member who is applying for coverage (or documentation that the SSN application is in progress)
• Proof of Ohio residency: utility bill, lease agreement, mortgage statement, or other document showing your name and Ohio address dated within the last 60 days
• Proof of U.S. citizenship or qualifying immigration status: birth certificate, U.S. passport, Certificate of Naturalization, or Permanent Resident Card (Green Card)
• Last 30 days of pay stubs or income documentation for every employed household member; self-employed applicants need 12 months of business records or a signed profit-and-loss statement
• Award letters for any Social Security, SSI, SSDI, VA, pension, or unemployment benefits currently received by any household member
• Pregnancy verification letter from a healthcare provider if applying under the pregnancy group (confirms due date and identifies the unborn child as a separate household member for income calculation purposes)

Processing timeline: Ohio processes standard Medicaid applications within 45 days of receipt. Pregnancy applications must be decided within 15 days under federal expedited-processing rules. Applications based on disability (aged, blind, or disabled tracks) can take 60 to 90 days because they require a separate medical determination. If Ohio fails to act within the required timeframe, applicants have the right to request a state hearing.

Common reasons applications get denied

• Income above the applicable threshold for the population group: the adult expansion group is capped at 138% FPL; children are capped at 211% FPL; pregnant women at 205% FPL. Even a few hundred dollars over the limit can result in denial if the applicant does not apply under the correct group.
• Failure to provide requested documentation within the timeframe: Ohio sends a written request for missing documents and gives the applicant a specific deadline. Missing the deadline results in automatic denial (though the applicant can reapply immediately).
• Residency cannot be verified: applicants must document an Ohio address. Post office boxes alone are insufficient; a physical address or shelter address is required.
• Federal 5-year bar for certain immigrants: most lawful permanent residents who arrived after August 22, 1996 must wait 5 years before qualifying for federally funded Medicaid. Emergency Medicaid may still be available regardless of immigration status.
• Excess assets for aged, blind, or disabled applicants: ABD and long-term care Medicaid require countable assets under $2,000 for a single individual. Applicants who transferred assets within the 60-month lookback period may face a penalty period during which long-term care Medicaid is unavailable.

If your child's income is above the Ohio Medicaid limit but below 211% FPL

Ohio integrates CHIP into the Medicaid program through Healthy Start, which covers children from birth through age 18 in households with income up to 211% of the Federal Poverty Level. For a family of four in 2026, that is $69,630 per year. Unlike some states with separate CHIP programs, Ohio applies through the same benefits.ohio.gov portal and uses the same eligibility process. Children who exceed 211% FPL may qualify for subsidized marketplace coverage through the ACA; use the national income limits comparison page to see thresholds across all 50 states.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older with limited income: Ohio Medicare Savings Programs

Ohio administers three Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries. The Qualified Medicare Beneficiary (QMB) program covers Medicare Part A and Part B premiums, deductibles, and cost-sharing for individuals with income up to 100% FPL ($15,960/year in 2026). The Specified Low-Income Medicare Beneficiary (SLMB) program pays Part B premiums for individuals with income between 100% and 120% FPL. The Qualifying Individual (QI) program covers Part B premiums for individuals with income between 120% and 135% FPL. Dual-eligible Ohioans (enrolled in both Medicare and Medicaid) also have access to the Next Generation MyCare program launched in January 2026, which coordinates medical, behavioral health, and long-term care services in 29 Ohio counties. Apply through benefits.ohio.gov or call 1-800-324-8680.

Read the Medicare eligibility guide

Frequently Asked Questions