Ohio Medicaid home care: PASSPORT, Ohio Home Care Waiver and self-direction

Ohio pays for care at home through Medicaid waivers run by the Ohio Department of Medicaid (ODM). PASSPORT is for adults 60 and older, the Ohio Home Care Waiver is for people with physical disabilities, and self-direction lets members hire their own caregivers, including family in some cases.

How care at home is paid for here

ODM says home- and community-based services (HCBS) let Ohioans served by Medicaid get health care services and support in their own home or community instead of a nursing home, hospital or other long-term care facility. It lists four waiver programs for older adults and people with disabilities who meet a nursing facility level of care, and three waiver programs for people with developmental disabilities who meet the appropriate level of care. Medicaid.gov lists ODM as the state Medicaid agency.

PASSPORT

ODM's September 2025 fact sheet says to be eligible for the PASSPORT Waiver you must meet the Medicaid financial criteria set by your county Job and Family Services office, meet a nursing facility level of care and be 60 or older. ODM is the administrative agency. The Ohio Department of Aging (ODA) is the operating agency, and PASSPORT Administrative Agencies provide case management.

ODA describes PASSPORT as having two parts: a phone pre-admission screening, then home care with a case manager who builds a package of in-home services. The services listed by ODM include adult day health, personal care aide, home care attendant, homemaker, home delivered meals, home maintenance and chore, home modification, waiver nursing, out-of-home respite, and structured family caregiving. See structured family caregiving in Ohio.

Ohio Home Care Waiver

ODM describes the Ohio Home Care Waiver (OHCW) as a waiver for people with physical disabilities and unstable medical conditions, so they can receive care at home and in their communities instead of nursing facilities, hospitals or rehabilitation facilities. To be eligible you must meet Medicaid criteria or be enrolled in Medicaid, meet a nursing facility level of care, and meet the other requirements in Ohio Administrative Code Rule 5160-46-02. Once ODM receives a request, it assigns a case management agency to assess your needs, then assigns a case manager to develop your person-centered care plan.

Self-direction

ODM says self-direction became available under the Ohio Home Care Waiver on October 1, 2024, and existing self-directed services expanded under the MyCare Waiver on November 15, 2024. Self-direction lets people use employer authority (control who they hire and how they manage them), budget authority (decide how funds are spent), or both. ODM names Public Partnerships LLC (PPL) as the financial management service. Details are in self-direction in Ohio.

Who can be paid

ODM's Self-Direction 101 says individuals can have family members work as paid caregivers. ODM's Direct Care Worker Relationship Rule, OAC 5160-44-32, effective January 1, 2024, allows parents of minor children and spouses to serve as direct care workers of waiver personal care and nursing services, and other relatives designated or appointed legal authority to serve as direct care workers of waiver services. See paid family caregiver in Ohio.

How to request services

1. Fill in ODM Form 02399, Request for Medicaid Home and Community-Based Services (HCBS) Waiver.
2. Submit it to your county Department of Job and Family Services or to your regional PASSPORT Administrative Agency. ODM links directories for both.
3. For help, Ohio Benefits Long-Term Services and Supports (OBLTSS) takes calls at 844-644-6582, and the Medicaid Consumer Hotline is 800-324-8680.
4. Expect a level of care assessment and a person-centered care plan from your assigned case manager.

If you need Medicaid itself, ODM links a step-by-step guide and a "who qualifies" page.

Questions to ask when you call

• Has my Form ODM 02399 reached my county Department of Job and Family Services or PASSPORT Administrative Agency?
• Which waiver fits me: PASSPORT because I am 60 or older, or the Ohio Home Care Waiver because I have a physical disability?
• Who is my case manager, and when is my level of care assessment?
• Would I like to self-direct any services, and which of my services can be self-directed on my waiver?
• If I want my spouse or my child's parent to be a paid caregiver, when will the Extraordinary Care Instrument be done?
• If I self-direct, how do I register my caregiver with the financial management service, and who do I call if a paycheck is wrong?
• Do I want an agency provider or a non-agency provider for my services?

Terms you will see

• Level of care: the evaluation of your physical, mental, social and emotional status that decides whether you meet a nursing facility level of care.
• PAA: PASSPORT Administrative Agency, which provides case management for PASSPORT.
• Person-centered care plan: the written plan your case manager builds with you.
• Employer authority and budget authority: the two parts of self-direction.
• Extraordinary Care Instrument: the ODM screening tool used when a spouse or a parent of a minor is considered as a direct care worker.
• FMS: the financial management service that processes pay for self-directed caregivers.
• NAP: a non-agency provider, which the Ohio Home Care Waiver handbook says you may choose instead of an agency-based provider.

What this page does not cover

We have not described the Ohio waivers for people with developmental disabilities, MyCare Ohio's managed care rules, or the Assisted Living Waiver. For providers, see intellectual and developmental disability services in Ohio.

Where Carevo fits

Carevo is a connection platform and directory. We do not run any Ohio waiver, assess eligibility or vouch for providers. The care-type links below show providers that serve your area.

Programs in Ohio

• Self-Direction (Ohio Home Care and MyCare Waivers): Ohio's self-direction option lets members of the Ohio Home Care Waiver and MyCare Waiver hire, schedule and pay their own caregivers, including some family members, with a financial management service handling payroll.
• Structured Family Caregiving (PASSPORT): Since October 2024, Ohio's PASSPORT waiver includes structured family caregiving. An agency employs or contracts a caregiver who lives with the participant and gives daily care.

Find providers in Ohio

• Home care in Ohio
• Home health care in Ohio
• Nursing homes in Ohio
• Intellectual and developmental disability services in Ohio
• Paid family caregiver in Ohio