How to Pay for In-Home Care
How to Pay for Home Care in Ohio
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
Ohio families typically start by screening adults 60 and older for PASSPORT, the main aging HCBS pathway for those who meet Medicaid and nursing-facility level-of-care criteria, with a benefit package that includes personal care, Choices participant direction, respite, meals, home modifications, nursing, and Structured Family Caregiving. Eligible Ohio Medicaid members from birth through age 59 who meet a nursing-facility-based level of care should look at the Ohio Home Care Waiver for similar supports, while qualifying dual Medicare-Medicaid members can use Next Generation MyCare, now available statewide as of August 2026, to coordinate medical and long-term-services benefits. Those with intellectual/developmental disabilities should screen the DODD waivers (Individual Options, Level One, and SELF) for participant-directed homemaker, personal care, and goods and services, and families should also check HOME Choice for institutional transitions and PACE where a local service area exists, layering on Medicare Savings, food and energy assistance, property-tax relief, Golden Buckeye, and Veteran benefits.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Ohio Medicaid HCBS
PASSPORT Waiver
YesHelps pay for: Comprehensive home- and community-based services that can replace or reduce privately purchased long-term care.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Call the local Area Agency on Aging for assessment and PASSPORT screening.
Good to know: Family caregiver payment: Depends on service; participant direction and Structured Family Caregiving create paid-caregiver routes
Ohio Home Care Waiver
YesHelps pay for: Home and community-based long-term services for Medicaid members through age 59 who meet nursing-facility-based level of care.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Apply/request HCBS waiver screening through Ohio Medicaid or an approved LTSS agency.
Good to know: Family caregiver payment: Depends on service; SFC and certain qualified relative-provider routes may apply
Paid Family Caregiver / PASSPORT
PASSPORT Structured Family Caregiving
YesHelps pay for: Live-in/shared-living support for an eligible adult who needs daily personal care and household support.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply. Participant must be 18+ and live with the caregiver in a private home.
How to start: Ask the AAA/care manager specifically about Structured Family Caregiving.
Good to know: Family caregiver payment: Yes - qualified caregiver may be paid through the approved SFC agency model; spouse/legal-representative rules apply
Participant-Directed / PASSPORT
Choices Home Care Attendant
YesHelps pay for: Participant serves as employer of record and can hire, train, schedule and dismiss a qualified attendant with fiscal-management support.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request the Choices employer-authority option during PASSPORT planning.
Good to know: Family caregiver payment: Many relatives may serve when qualified. A spouse or parent of a minor child may be paid only under Ohio extraordinary-care/no-other-willing-and-able-provider rules; generally 40 hours/week unless an exception applies.
Participant-Directed Personal Care
YesHelps pay for: Hands-on ADL/IADL assistance under PASSPORT employer authority.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Ask the PASSPORT case manager whether participant-directed personal care is authorized in the plan.
Good to know: Family caregiver payment: Many relatives may serve when qualified. A spouse or parent of a minor child may be paid only under Ohio extraordinary-care/no-other-willing-and-able-provider rules; generally 40 hours/week unless an exception applies.
PASSPORT Waiver Service
PASSPORT Home Care Attendant
YesHelps pay for: Personal care plus certain health-related tasks when authorized in the person-centered plan.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: Potentially - relationship/provider rules apply
PASSPORT Homemaker
YesHelps pay for: Housekeeping, laundry, meal preparation and household support needed to remain safely at home.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: Potentially - provider and relationship rules apply
PASSPORT Adult Day
YesHelps pay for: Daytime health, supervision and activities that can reduce in-home caregiving hours.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No direct family wage
PASSPORT Home-Delivered Meals
YesHelps pay for: Prepared meals delivered to the home, reducing meal-preparation burden.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No
PASSPORT Alternative Meals
YesHelps pay for: Alternative meal support authorized within the waiver benefit.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No
PASSPORT Home Maintenance & Chore
YesHelps pay for: Home maintenance/chore tasks necessary for health, welfare or safe community living.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: Potentially only if provider/participant-direction rules allow
PASSPORT Home Modification
IndirectHelps pay for: Environmental adaptations that improve safety or independence in the home.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No direct wage
PASSPORT Home Medical Equipment & Supplies
IndirectHelps pay for: Approved equipment and supplies that reduce out-of-pocket care-related purchases.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No
PASSPORT Personal Emergency Response System
IndirectHelps pay for: Emergency-alert technology that can reduce safety risk and some supervision needs.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No
PASSPORT Out-of-Home Respite
YesHelps pay for: Short-term relief for unpaid caregivers in an authorized out-of-home setting.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No - spouse/parent paid-care rules cannot be used for respite
PASSPORT Non-Medical Transportation
YesHelps pay for: Transportation to approved community activities/services under the person-centered plan.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No direct family wage unless a separately eligible provider arrangement applies
PASSPORT Nutrition Consultation
YesHelps pay for: Dietitian/nutrition consultation for assessed needs.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No
PASSPORT Social Work / Counseling
YesHelps pay for: Professional counseling/social-work support tied to waiver goals.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No
PASSPORT Community Integration
YesHelps pay for: Supports participation and independence in community life.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: Usually provider service
PASSPORT Community Transition
YesHelps pay for: One-time transition supports for eligible people moving from institutional care to the community.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No direct wage
PASSPORT Enhanced Community Living
YesHelps pay for: Enhanced community-living supports under the PASSPORT service package.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: Usually provider service
PASSPORT Vehicle Modifications
IndirectHelps pay for: Authorized vehicle adaptations that support safe community access.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: No
PASSPORT Waiver Nursing
YesHelps pay for: Skilled nursing under the waiver plan.
Who qualifies: Age 60+ at enrollment; Ohio Medicaid eligible; intermediate or skilled nursing-facility level of care; needs can be safely met in an HCBS setting; service-plan and available-slot requirements apply.
How to start: Request assessment and authorization through the PASSPORT care manager.
Good to know: Family caregiver payment: A qualified relative may potentially provide under applicable Ohio relationship/provider rules
Paid Family Caregiver / Ohio Home Care
Ohio Home Care Structured Family Caregiving
YesHelps pay for: Live-in/shared-living daily personal care and household support through an approved SFC agency.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply. Participant must be 18+ for SFC and live with the caregiver in a private home.
How to start: Ask the waiver care manager specifically about Structured Family Caregiving.
Good to know: Family caregiver payment: Yes - qualified caregiver route; spouse/parent/legal-representative rules are restricted by rule 5160-44-32
Ohio Home Care Waiver Service
Ohio Home Care Home Care Attendant
YesHelps pay for: Personal care plus certain health-related tasks under the waiver plan.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: Potentially - qualified relative/provider rules apply
Ohio Home Care Personal Care Aide
YesHelps pay for: Hands-on ADL/IADL assistance in the home.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: Potentially - agency/provider and relationship rules apply
Ohio Home Care Waiver Nursing
YesHelps pay for: Skilled nursing authorized under the waiver.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: Potentially for a qualified licensed relative under applicable rules
Ohio Home Care Adult Day Health Center
YesHelps pay for: Daytime health and supportive services that can reduce home-care hours.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No
Ohio Home Care Home-Delivered Meals
YesHelps pay for: Prepared meals delivered to the home.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No
Ohio Home Care Home Maintenance & Chores
YesHelps pay for: Authorized household maintenance/chore tasks needed for safe community living.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: Potentially only under an eligible provider arrangement
Ohio Home Care Home Modification
IndirectHelps pay for: Environmental adaptations needed for health, safety or independence.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No
Ohio Home Care Community Integration
YesHelps pay for: Community participation and independence supports.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: Usually provider service
Ohio Home Care Community Transition
YesHelps pay for: Transition supports tied to moving from institutional care into the community.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No direct wage
Ohio Home Care Personal Emergency Response System
IndirectHelps pay for: Emergency-response technology for safety at home.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No
Ohio Home Care Out-of-Home Respite
YesHelps pay for: Authorized respite outside the home to relieve an unpaid caregiver.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No - spouse/parent paid-care exception cannot be used for respite
Ohio Home Care Vehicle Modifications
IndirectHelps pay for: Authorized vehicle adaptations.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No
Ohio Home Care Supplemental Transportation
YesHelps pay for: Authorized transportation beyond otherwise available Medicaid transportation.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No direct family wage unless separately qualified
Ohio Home Care Supplemental Adaptive / Assistive Devices
IndirectHelps pay for: Authorized adaptive or assistive devices not otherwise covered.
Who qualifies: Birth through age 59; Ohio Medicaid eligible; nursing-facility-based level of care and need for waiver services; needs must be safely met in an HCBS setting. At age 60, PASSPORT transition rules may apply.
How to start: Request through the Ohio Home Care waiver care manager/person-centered plan.
Good to know: Family caregiver payment: No
Integrated Medicare-Medicaid LTSS
Next Generation MyCare / MyCare Ohio HCBS Waiver
YesHelps pay for: Coordinates Medicare, Medicaid and long-term services/supports through a MyCare plan and Area Agency on Aging partnership.
Who qualifies: For qualifying Ohioans enrolled in both Medicare and Medicaid who meet Next Generation MyCare enrollment/waiver criteria; plan and county enrollment rules apply. Program became available across the state by August 1, 2026.
How to start: Contact Ohio Medicaid/MyCare plan and AAA for enrollment and LTSS assessment.
Good to know: Family caregiver payment: Depends on service; participant-directed and SFC routes are available
Paid Family Caregiver / MyCare
MyCare Structured Family Caregiving
YesHelps pay for: Shared-living caregiver support for eligible adult waiver participants.
Who qualifies: For qualifying Ohioans enrolled in both Medicare and Medicaid who meet Next Generation MyCare enrollment/waiver criteria; plan and county enrollment rules apply. Program became available across the state by August 1, 2026. SFC participant must be 18+ and live with caregiver in a private home.
How to start: Ask MyCare care manager/AAA about SFC.
Good to know: Family caregiver payment: Yes - qualified live-in caregiver through SFC agency; spouse/legal-representative restrictions apply
Participant-Directed / MyCare
MyCare Choices Home Care Attendant
YesHelps pay for: Employer-authority option allowing the participant to direct an individual attendant with fiscal-management support.
Who qualifies: For qualifying Ohioans enrolled in both Medicare and Medicaid who meet Next Generation MyCare enrollment/waiver criteria; plan and county enrollment rules apply. Program became available across the state by August 1, 2026.
How to start: Ask MyCare care manager for employer-authority/self-direction options.
Good to know: Family caregiver payment: Many relatives may serve when qualified. A spouse or parent of a minor child may be paid only under Ohio extraordinary-care/no-other-willing-and-able-provider rules; generally 40 hours/week unless an exception applies.
MyCare Self-Directed Personal Care / Home Care Attendant
YesHelps pay for: Self-directed personal assistance/home-care attendant services under current MyCare waiver rules.
Who qualifies: For qualifying Ohioans enrolled in both Medicare and Medicaid who meet Next Generation MyCare enrollment/waiver criteria; plan and county enrollment rules apply. Program became available across the state by August 1, 2026.
How to start: Request self-direction during person-centered planning.
Good to know: Family caregiver payment: Many relatives may serve when qualified. A spouse or parent of a minor child may be paid only under Ohio extraordinary-care/no-other-willing-and-able-provider rules; generally 40 hours/week unless an exception applies.
MyCare Self-Directed Waiver Nursing / Goods & Services
Yes / IndirectHelps pay for: Selected waiver nursing and self-directed goods/services can use budget or employer authority when authorized.
Who qualifies: For qualifying Ohioans enrolled in both Medicare and Medicaid who meet Next Generation MyCare enrollment/waiver criteria; plan and county enrollment rules apply. Program became available across the state by August 1, 2026.
How to start: Ask the care manager which self-directed authorities are available in the approved plan.
Good to know: Family caregiver payment: Potentially for nursing if worker is properly licensed/qualified; goods/services are not caregiver wages
Medicaid Transition
HOME Choice
IndirectHelps pay for: Transition assistance for eligible Ohio Medicaid members moving from a long-term-care facility back to a home/community setting.
Who qualifies: Must be approved for Ohio Medicaid and currently reside in an eligible Ohio long-term-care facility for at least 60 consecutive days; transition must be safe and sustainable.
How to start: Apply through HOME Choice and coordinate with facility discharge planning.
Good to know: Family caregiver payment: No direct family wage
Integrated Long-Term Care
PACE
YesHelps pay for: All-inclusive Medicare/Medicaid medical, personal-care and long-term-care model designed to keep qualifying older adults living in the community.
Who qualifies: Age 55+, nursing-facility level of care, live in a PACE service area and can live safely in the community. Cannot remain simultaneously enrolled in listed Medicaid waivers/managed-care programs.
How to start: Contact a local PACE organization and verify service-area eligibility.
Good to know: Family caregiver payment: No separate family wage; PACE arranges/provides covered care
DODD Medicaid HCBS
Individual Options (IO) Waiver
YesHelps pay for: Broad HCBS for people with developmental disabilities, including homemaker/personal care, shared living and other supports.
Who qualifies: Developmental-disability eligibility, Medicaid/waiver financial and functional criteria, individual service plan and waiver enrollment/capacity requirements.
How to start: Start with the county board of developmental disabilities.
Good to know: Family caregiver payment: Potentially - family/provider rules apply; participant direction available for eligible services
Level One Waiver
YesHelps pay for: HCBS for people with developmental disabilities with a defined service package and participant-directed options.
Who qualifies: Developmental-disability eligibility, waiver criteria, service-plan authorization and enrollment/capacity requirements.
How to start: Start with the county board of developmental disabilities.
Good to know: Family caregiver payment: Potentially - family/provider rules apply; participant direction available
SELF Waiver
YesHelps pay for: Self-Empowered Life Funding waiver with strong self-direction and individual budget features.
Who qualifies: Developmental-disability eligibility, Medicaid/waiver criteria, person-centered budget and enrollment requirements.
How to start: Start with the county board and ask specifically about SELF.
Good to know: Family caregiver payment: Potentially - qualified family/provider rules apply
Participant-Directed / DODD
Participant-Directed Homemaker / Personal Care
YesHelps pay for: Allows eligible IO, Level One and SELF participants to direct selected homemaker/personal-care staff under Ohio rules.
Who qualifies: Must be enrolled in an applicable DODD waiver; worker must meet Medicaid/provider/employment requirements and service must be in the individual service plan.
How to start: Ask the SSA/county board to add participant-directed HPC to the service plan.
Good to know: Family caregiver payment: Many relatives may serve when qualified. A spouse or parent of a minor child may be paid only under Ohio extraordinary-care/no-other-willing-and-able-provider rules; generally 40 hours/week unless an exception applies.
Participant-Directed Goods & Services
IndirectHelps pay for: Budget-directed goods/services under applicable Level One and SELF waiver rules can offset disability-related supports that increase independence.
Who qualifies: Must be enrolled in an applicable waiver and item/service must meet rule and plan requirements and not be otherwise available through another payer.
How to start: Ask the SSA/county board about participant-directed goods and services.
Good to know: Family caregiver payment: No caregiver wage
Medicaid Eligibility Path
Medicaid Buy-In for Workers with Disabilities (MBIWD)
IndirectHelps pay for: Lets qualifying workers with disabilities retain Medicaid while earning income/resources within program rules, preserving access to covered home/community services.
Who qualifies: Worker with qualifying disability/medical-improvement status and other MBIWD eligibility requirements; current rule effective April 1, 2026.
How to start: Apply through Ohio Benefits/county JFS and ask specifically about MBIWD.
Good to know: Family caregiver payment: No direct caregiver wage
Medicaid State Plan
Medicaid Home Health
Yes - limited/skilled benefitHelps pay for: Medically necessary skilled nursing, aide and therapy services when state-plan criteria are met.
Who qualifies: Ohio Medicaid eligibility, medical necessity and state-plan/provider requirements; not a substitute for unlimited custodial care.
How to start: Ask treating clinician and Medicaid plan about home-health authorization.
Good to know: Family caregiver payment: No routine family wage unless separately enrolled/qualified as provider under applicable rules
Private Duty Nursing
Yes - skilled nursingHelps pay for: Extended skilled nursing for eligible Medicaid members with medical necessity and authorization.
Who qualifies: Ohio Medicaid eligibility, physician/medical necessity, prior authorization and provider requirements.
How to start: Ask Medicaid plan/care manager and treating clinician about PDN criteria.
Good to know: Family caregiver payment: Potentially only for properly licensed/enrolled qualified relatives under specific rules
Medicaid Transportation
Non-Emergency Medical Transportation
IndirectHelps pay for: Can reduce transportation costs for covered Medicaid medical services.
Who qualifies: Ohio Medicaid member; trip must meet covered-transport requirements and plan/county procedures.
How to start: Contact Medicaid managed-care plan or county transportation resource before the appointment.
Good to know: Family caregiver payment: No
Caregiver Support / Aging Network
National Family Caregiver Support Program / AAA Services
IndirectHelps pay for: Information, training, counseling, respite and supplemental caregiver supports can reduce unpaid-caregiver burden and purchased-care needs.
Who qualifies: Caregiver/care-recipient eligibility and local funding rules vary; services are administered through Ohio aging network/AAAs.
How to start: Call the local AAA and ask for caregiver support/respite screening.
Good to know: Family caregiver payment: Usually not a caregiver wage; respite/supplemental help varies by AAA and funding
Medicare Cost Offset
Medicare Savings Programs
IndirectHelps pay for: QMB/SLMB/QI-type assistance can pay some Medicare premiums and, depending on category, cost sharing, freeing household funds for care.
Who qualifies: Medicare beneficiary meeting Ohio Medicaid income/resource/program rules.
How to start: Apply through Ohio Benefits/county JFS; OSHIIP can provide counseling.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited/skilledHelps pay for: Intermittent skilled nursing, therapy and certain home health aide services for eligible homebound beneficiaries under Medicare rules.
Who qualifies: Must meet Medicare home-health eligibility, including need for qualifying skilled services and certification/plan-of-care requirements.
How to start: Ask the treating clinician and a Medicare-certified home health agency.
Good to know: Family caregiver payment: No routine family wage
Medicare Hospice
YesHelps pay for: Interdisciplinary end-of-life care can include nursing, aides, equipment, medications and respite related to the terminal illness.
Who qualifies: Medicare hospice eligibility/election and plan-of-care requirements apply.
How to start: Ask clinician/hospice for evaluation and compare Medicare-certified providers.
Good to know: Family caregiver payment: No direct family wage
Prescription Cost Offset
Medicare Part D Extra Help
IndirectHelps pay for: Reduces Part D premiums, deductibles and prescription costs, preserving funds for caregiving.
Who qualifies: Medicare beneficiary meeting Extra Help criteria; some people qualify automatically.
How to start: Apply through Social Security or ask OSHIIP for assistance.
Good to know: Family caregiver payment: No
Food Cost Offset
SNAP
IndirectHelps pay for: Monthly food assistance can reduce grocery costs and free household funds for home care.
Who qualifies: Household income/resource and program rules apply.
How to start: Apply through Ohio Benefits/county JFS.
Good to know: Family caregiver payment: No
Energy / Home Cost Offset
Ohio Energy Assistance / Weatherization
IndirectHelps pay for: Heating/utility and weatherization assistance can reduce household costs and improve home safety/comfort.
Who qualifies: Income and program-specific rules apply; benefits may be seasonal or funding-limited.
How to start: Use Ohio Aging Compass/energy-assistance resources or local community action agency.
Good to know: Family caregiver payment: No
Property Tax Relief
Ohio Homestead Exemption - Older / Disabled Homeowners
IndirectHelps pay for: Property-tax reduction can preserve funds for care for qualifying owner-occupants.
Who qualifies: Current law includes qualifying age 65+ and permanently/totally disabled homeowners, with income/legacy rules; file with county auditor. Law has another version effective Sept. 23, 2026, so recheck before quoting future-year amounts.
How to start: Contact the county auditor and review current Ohio Revised Code requirements.
Good to know: Family caregiver payment: No
Senior / Disability Discount
Golden Buckeye Card
IndirectHelps pay for: Discount program can reduce everyday spending on participating goods/services and preserve funds for care.
Who qualifies: Ohio resident age 60+; Ohio residents age 18-59 with permanent and total disability may also qualify under separate enrollment rules.
How to start: Apply through Ohio Department of Aging if not automatically enrolled.
Good to know: Family caregiver payment: No
Nutrition Cost Offset
Senior Farmers Market Nutrition / Aging Nutrition Resources
IndirectHelps pay for: Eligible older adults may receive nutrition supports that reduce food costs and support healthy aging; availability is program/season dependent.
Who qualifies: Age, income, geography, season and funding rules vary by program.
How to start: Ask the local AAA or use Aging Compass nutrition resources.
Good to know: Family caregiver payment: No
Communications Cost Offset
Lifeline / Affordable Communications Support
IndirectHelps pay for: Federal Lifeline can reduce phone/internet costs for qualifying low-income households, preserving funds for care and supporting caregiver communication.
Who qualifies: Income or qualifying-program eligibility under federal Lifeline rules.
How to start: Apply through the federal Lifeline administrator; AAA/financial resource sites can help locate assistance.
Good to know: Family caregiver payment: No
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: VA may authorize community-based aides to help an eligible Veteran with ADLs and selected daily tasks at home.
Who qualifies: VA health-care eligibility, clinical need, authorization and local provider availability; copays may apply. Ask the Veteran's VA primary care/social work team for assessment and authorization.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No direct family wage
Veteran-Directed Care
YesHelps pay for: Flexible self-directed budget for eligible Veterans needing personal care; participant has more choice over workers and services within local program rules.
Who qualifies: VA enrollment, clinical need and local VDC availability; availability varies by service area. Ask VA social work/care team whether VDC is available in the Veteran's Ohio service area.
How to start: Ask the VA social worker or care team about Veteran-Directed Care.
Good to know: Family caregiver payment: Often yes - family/friends may be hired subject to local VDC rules
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from authorized community providers.
Who qualifies: Clinical need, VA eligibility/authorization and provider availability. Request through the VA care team.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may provide in-home, adult-day or facility respite to give caregivers a break.
Who qualifies: VA enrollment, clinical need and local availability/authorization. Ask VA social work or Caregiver Support about respite.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No direct wage
VA Adult Day Health Care
Indirect / daytime careHelps pay for: Health, rehabilitation, socialization and supervision in an adult-day setting can reduce in-home caregiver hours.
Who qualifies: VA eligibility, clinical need, authorization and local availability. Ask the VA care team whether adult day health is appropriate and available.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No
VA Home Based Primary Care
Yes - medical home careHelps pay for: Interdisciplinary primary care delivered in the home can help medically complex Veterans remain at home.
Who qualifies: Generally for Veterans with complex chronic conditions for whom routine clinic care is difficult; VA clinical acceptance required. Ask VA primary care for HBPC screening.
How to start: Ask the VA social worker or care team about VA Home Based Primary Care.
Good to know: Family caregiver payment: No
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Indirect - caregiver stipend supports home careHelps pay for: Eligible primary family caregivers may receive a monthly stipend plus training, support and other benefits.
Who qualifies: Veteran and caregiver must meet PCAFC clinical/service criteria; approval is not based solely on diagnosis or age. Contact an Ohio VA Caregiver Support Team for application/screening.
How to start: Ask the VA social worker or care team about Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Good to know: Family caregiver payment: Yes - eligible primary family caregiver
Program of General Caregiver Support Services (PGCSS)
IndirectHelps pay for: Coaching, education, peer support and caregiver resources can reduce burnout and help sustain care at home.
Who qualifies: For caregivers of Veterans enrolled in VA health care; PCAFC approval is not required for general supports. Contact an Ohio VA Caregiver Support Team.
How to start: Ask the VA social worker or care team about Program of General Caregiver Support Services (PGCSS).
Good to know: Family caregiver payment: No monthly stipend under PGCSS
VA Pension with Aid & Attendance / Housebound
Indirect - cash benefit can help fund careHelps pay for: Additional pension amounts can help an eligible wartime Veteran or survivor with care and household costs.
Who qualifies: Pension eligibility plus Aid & Attendance or Housebound criteria; income/net-worth rules apply. Work with a VA-accredited representative/VSO to file pension and medical evidence.
How to start: Ask the VA social worker or care team about VA Pension with Aid & Attendance / Housebound.
Good to know: Family caregiver payment: No designated caregiver wage
VA Community Care Network Region 2
Yes - if authorized service includes home/community careHelps pay for: Authorized community care can provide covered services outside VA when eligibility/referral requirements are met.
Who qualifies: Ohio is in CCN Region 2, administered by Optum; community care generally requires VA authorization/referral. Start with VA care team/community-care office rather than self-referring as ordinary insurance.
How to start: Ask the VA social worker or care team about VA Community Care Network Region 2.
Good to know: Family caregiver payment: Depends on specific VA benefit
Ohio County Veterans Service Offices
IndirectHelps pay for: Free county-level assistance can help identify/file VA disability, pension, health, survivor and Ohio Veteran benefits.
Who qualifies: Benefit eligibility varies; county veterans service offices provide local navigation and accredited assistance. Contact the county Veterans Service Commission/Office.
How to start: Ask the VA social worker or care team about Ohio County Veterans Service Offices.
Good to know: Family caregiver payment: No
Ohio Disabled Veteran Homestead Exemption
IndirectHelps pay for: Property-tax reduction for qualifying disabled Veterans can preserve household funds for care.
Who qualifies: Ohio law provides a separate homestead reduction for qualifying disabled Veterans/surviving spouses; disability rating, ownership/occupancy and filing documentation rules apply. Contact county auditor and a Veterans Service Officer for documentation help.
How to start: Ask the VA social worker or care team about Ohio Disabled Veteran Homestead Exemption.
Good to know: Family caregiver payment: No
Where Ohio Families Can Start
Not sure where to begin? Match your situation to a contact below.
Aging services, caregiver resources, Golden Buckeye and statewide aging navigation
Ohio Department of Aging
Primary PASSPORT intake, caregiver support, options counseling and local aging services
Area Agency on Aging Locator
Medicaid member questions, Ohio Home Care, MyCare and HOME Choice navigation
Ohio Medicaid Consumer Hotline
Apply for Medicaid, SNAP, cash assistance and related benefits
Ohio Benefits / County JFS
PASSPORT assessment, waiver enrollment, Choices self-direction and Structured Family Caregiving
PASSPORT / Local AAA
Integrated Medicare-Medicaid plan and LTSS enrollment/care-management questions
Next Generation MyCare
IO, Level One, SELF, participant direction and developmental-disability services
Ohio DODD / County Board
All-inclusive long-term care for eligible adults 55+ in a PACE service area
PACE
Free Medicare, Medicare Savings Program and Extra Help counseling
OSHIIP - Ohio Medicare Counseling
Local food, housing, utility, transportation and caregiver-support referrals
211 Ohio
PCAFC, PGCSS, respite and VA caregiver resources
VA Caregiver Support
Before You Rely on Any Payment Source
Planning Point
Why It Matters
Use age 60 as the PASSPORT / Ohio Home Care fork
PASSPORT requires age 60+ at enrollment. The Ohio Home Care waiver covers birth through age 59; Ohio rules provide transition considerations as someone reaches 60. Start with the correct operational pathway so the application is not delayed.
Structured Family Caregiving is now a major Ohio paid-caregiver route
Ohio rule 5160-44-33 applies SFC to PASSPORT, Ohio Home Care and MyCare. It is a shared-living model: the adult participant lives with the caregiver in a private home, needs daily personal care/household support, and the caregiver works through an approved agency/provider model.
Spouse and parent-of-minor payment is an exception, not an automatic benefit
Rule 5160-44-32 requires no other willing/able provider, a health-and-safety determination, extraordinary-care documentation, and generally limits paid care from a spouse or parent(s) of a minor child to 40 hours/week unless an exception is approved. These services cannot be used for respite.
Other relatives with legal decision-making authority also have limits
Adult relatives who hold certain legal/representative roles may be able to provide covered services, but paid care is generally limited to 40 hours/week per relative with legal decision-making authority unless an authorized exception applies.
Participant direction still requires worker/provider compliance
PASSPORT Choices, MyCare self-direction and DODD participant-directed services let the participant exercise meaningful employer/budget authority, but workers still must meet enrollment, background, training, EVV/FMS and service-plan requirements. A designated FMS representative cannot also be the direct care worker under the family-provider rule.
Next Generation MyCare reached the remaining counties August 1, 2026
Ohio Medicaid’s official rollout schedule shows the final AAA8 counties joining August 1, 2026. For dual-eligible clients, verify current MyCare plan assignment, network and AAA care-management contacts rather than relying on pre-2026 county lists.
PASSPORT enrollment is subject to an available waiver slot
The current PASSPORT eligibility rule requires an available slot within the CMS-authorized enrollment limit. Ohio also maintains unified waiting-list rules for PASSPORT/PACE/Assisted Living if eligible applicants cannot immediately be enrolled.
PACE is service-area limited and cannot be stacked with listed Medicaid waivers
PACE requires age 55+, nursing-facility level of care and residence in a PACE service area. Current Ohio rules require disenrollment from listed Medicaid waiver/managed-care programs when enrolling in PACE, so compare the whole benefit package before switching.
HOME Choice is a transition pathway, not a general community application
HOME Choice is designed for eligible Ohio Medicaid members currently in a qualifying long-term-care facility for at least 60 consecutive days. Screen before discharge so housing, transition supports and community services can be coordinated.
DODD family-caregiver payment uses the same Ohio relationship guardrails
Participant-directed homemaker/personal care can be available under IO, Level One and SELF, but spouse/parent/legal-representative payment remains subject to rule 5160-44-32 and applicable DODD waiver/provider rules.
Ohio homestead law is changing again September 23, 2026
The current March 20, 2026 version of ORC 323.152 already reflects 2026 changes and the Ohio Laws page flags another version effective September 23, 2026. Recheck the law before publishing future-year income thresholds or exemption amounts.
Use Veteran benefits as a separate funding layer
Ohio is in VA Community Care Network Region 2, administered by Optum. VA home care, Veteran-Directed Care, PCAFC, Aid & Attendance and disabled-veteran property-tax relief have separate eligibility/authorization systems and may layer with state/federal benefits subject to payer rules.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Ohio to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in Ohio
These providers serve families in Ohio and can help you apply what you've learned above to your specific situation.
Central Star Home Health Services
Serving Ohio
Central Star Home Health Services provides home care from its Ontario, OH office, serving Richland County and the surrounding north-central Ohio communities.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Skilled Nursing Care at Home • In-Home Rehabilitation • Dementia & Alzheimer's Care • Hospice Supportive Care • Hospital-to-Home Care • Client Advocacy Services • Healthcare Staffing • Snowbird Services
Communities Served
Ontario, Ashland, Bellville and surrounding areas
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Queen City Elder Care
Serving Ohio
Queen City Elder Care provides home care services in Cincinnati, OH and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Amberley, Anderson, Cincinnati and surrounding areas
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Triad Home Health Services
Serving Ohio
Triad Home Health Services provides home care services in Columbus, OH and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Franklin County, Delaware County, Licking County and surrounding areas
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