Medicare vs Medicaid: What Actually Covers Senior Care in Ohio?

BrightBridge Senior Advisors · February 12, 2026

Medicare and Medicaid sound alike, and people mix them up constantly. That confusion gets expensive when you're trying to figure out how to pay for a parent's care. Families call us every week assuming Medicare will cover assisted living. It won't. And that surprise hits hard when you're already stressed.

Let's clear this up once and for all. Here's what Medicare covers, what Medicaid covers, and how Ohio's specific programs work for senior care.

The Quick Version

Medicare is federal health insurance for people 65 and older. It covers hospital stays, doctor visits, and short-term rehabilitation. It does not cover long-term senior care like assisted living or custodial nursing home stays.

Medicaid is a joint federal-state program for people with limited income and assets. In Ohio, Medicaid covers nursing home care and, through waiver programs, can help pay for assisted living and in-home care.

That's the 30-second answer. But the details matter a lot, so let's dig in.

What Medicare Covers (and Doesn't)

Medicare is great for medical care. If your parent needs a hip replacement, a hospital stay after a heart attack, or regular visits to their doctor in Columbus, Medicare handles that. Here's what it covers related to senior care:

Skilled nursing facility care (limited). Medicare covers up to 100 days in a skilled nursing facility after a qualifying hospital stay of at least 3 days. Days 1 through 20 are covered in full. Days 21 through 100 require a daily copay (around $204 in 2026). After day 100, Medicare pays nothing.

This is rehabilitation, not long-term care. It covers recovery from surgery, a stroke, or a major illness. Once rehabilitation ends, so does Medicare coverage.

Home health care (limited). Medicare covers part-time skilled nursing and therapy services at home if ordered by a doctor. But it doesn't cover 24-hour care, homemaker services, or personal care aides who help with bathing and dressing.

What Medicare does NOT cover:

• Assisted living communities
• Memory care communities
• Long-term nursing home stays (custodial care)
• Adult day care
• Personal care aides for daily activities
• Room and board in any care facility

This surprises a lot of families. Most people assume that paying Medicare taxes for 40 years means the government will cover their care when they're old. That's simply not how the program works.

What Ohio Medicaid Covers

Medicaid is where the real long-term care coverage lives. But you have to qualify financially, and the rules are specific to Ohio.

Nursing home care. Ohio Medicaid covers the full cost of nursing home care for people who qualify. This is the most comprehensive Medicaid benefit for seniors. The state pays the facility directly, and the resident contributes most of their income toward the cost (keeping a small personal needs allowance).

The PASSPORT waiver. For seniors who need nursing home-level care but want to stay in a less restrictive setting, Ohio offers the PASSPORT program. PASSPORT can cover services like assisted living, home health aides, adult day care, home-delivered meals, and medical equipment.

PASSPORT is huge for Columbus families because it lets your parent get care in an assisted living community instead of a nursing home, with Medicaid picking up a significant portion of the cost. Not every assisted living community accepts PASSPORT, but many in the Columbus metro do.

Ohio Medicaid: Who Qualifies?

Qualifying for Ohio Medicaid requires meeting both income and asset limits. Here are the current thresholds:

For a single person:

• Monthly income limit: approximately $2,829 (300% of SSI federal benefit rate)
• Countable asset limit: $2,000

For married couples (when one spouse needs care):

• The "community spouse" (the one staying home) can keep a portion of the couple's assets, currently up to about $154,140
• The community spouse's income is generally not counted

Important: your parent's primary residence typically doesn't count as an asset if a spouse lives there, if there's intent to return home, or if equity is below $713,000. Their car doesn't count either.

Ohio also has a "look-back period" of 5 years. If your parent gave away assets or transferred property within the last 5 years to get below the asset limit, Medicaid can impose a penalty period. This is why planning ahead matters so much. Talk to an elder law attorney before making any financial moves.

How to Apply for Ohio Medicaid

The application process has a few steps:

For nursing home Medicaid: Apply through your local county Department of Job and Family Services. In Franklin County, that's the Franklin County JFS office. You'll need documentation of income, assets, medical records, and identification.

For the PASSPORT waiver: Start with the Central Ohio Area Agency on Aging (COAAA) if you're in Franklin County or surrounding counties. They handle the intake and assessment process. A case manager will evaluate your parent's care needs to determine if they meet the nursing home level of care requirement.

Be prepared for the PASSPORT waitlist. Depending on the county, you might wait several weeks to several months. Apply as early as possible, even if you don't need services immediately.

Can You Have Both Medicare and Medicaid?

Yes. Many seniors qualify for both, and people in this situation are called "dual eligible." When someone has both, Medicare covers their medical care (doctor visits, hospital stays, prescriptions) and Medicaid covers their long-term care needs (nursing home, assisted living through PASSPORT, etc.).

Having both programs working together can cover a significant portion of total care costs. If your parent is on Medicare and you think they might qualify for Medicaid, it's absolutely worth applying.

Medicare Advantage Plans: A Note

Some Medicare Advantage plans (Part C) in the Columbus area offer supplemental benefits that standard Medicare doesn't, like limited personal care hours, meal delivery, or transportation. These aren't the same as paying for assisted living, but they can supplement other care arrangements.

If your parent has a Medicare Advantage plan, review the benefits carefully. Some plans offered by insurers in the Columbus market include surprisingly helpful extras for seniors living at home.

The Bottom Line

Here's the reality. Medicare won't pay for your parent's assisted living or long-term nursing home stay. Medicaid will, but only if they qualify financially. And the application process takes time.

Start planning early. Talk to an elder law attorney about Medicaid planning. Contact COAAA about the PASSPORT program. And if you're feeling overwhelmed by all of this, that's completely normal.

For a broader look at all the ways to fund senior care, including VA benefits and insurance options, check out our complete guide on how to pay for senior care in Ohio.