Patient liability applies after eligibility
Ohio calculates post-eligibility treatment of income in a stated order, beginning with gross monthly income and then applying specified exclusions and deductions. The remaining amount is patient liability paid to the facility, while Medicaid pays the balance of the Medicaid rate (OAC 5160:1-6-07).
For 2026, Ohio's nursing-facility personal-needs allowance is $75 per month for an individual and $150 for a couple. CMS approved Ohio's related state plan amendment effective January 1, 2026 (CMS-approved Ohio SPA 25-0022).
Resident allowance: Ohio's 2026 personal-needs allowance is $75/month for an individual nursing-facility resident. It is one deduction in the patient-liability calculation, not a separate benefit that eliminates the resident's share of cost (
OAC 5160:1-6-07;
CMS Ohio SPA).
VA pension treatment has a narrow rule
For patient-liability purposes, Ohio's rule excludes VA pensions, including Aid & Attendance, up to $90 per month for a qualifying veteran or surviving spouse without a dependent minor or disabled child who is in a nursing facility or receiving HCBS waiver services. The rule places this exclusion before the separate personal-needs allowance deduction (OAC 5160:1-6-07).
Spousal and family income allowances, health-insurance premiums, and incurred medical expenses may also affect the final liability calculation under the rule. A facility bill should therefore be reviewed against the individual's current facts rather than estimated from gross income alone (OAC 5160:1-6-07).
Get current case-specific guidance
Income, resources, transfer history, marital status, and the date of institutionalization all can change the result. Ohio's standards are updated, so a current eligibility review is essential before relying on a published amount (ODM 2026 standards).
Compare Florida's nursing-home Medicaid page for another state's resident-payment structure. For broader program context, see Medicaid (Baseline).
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