Key takeaway
Ohio has multiple Medicaid waivers and managed care plans that can pay family caregivers. Your path depends on age, level of care, region, and whether you want consumer-directed services.
- PASSPORT Waiver serves Ohioans 60+ at nursing-facility level of care and can pay family caregivers.
- MyCare Ohio (in select counties) bundles Medicare and Medicaid; family caregivers are paid via the participant-directed option.
- Choices Waiver is the consumer-directed alternative to PASSPORT, allowing the participant to hire family.
- Veterans can use Aid & Attendance or Veteran Directed Care (VDC can pay a spouse).
Overview
Ohio pays family caregivers primarily through Medicaid waivers administered by the Ohio Department of Aging, the Ohio Department of Medicaid, and managed care plans. PASSPORT is the most widely used path for older adults and can pay family members for personal care. The Choices Waiver is the consumer-directed twin of PASSPORT — the same eligibility, but the participant hires and supervises their own caregiver.
In counties that use MyCare Ohio, dually eligible adults (Medicare and Medicaid) get long-term services through a single managed care plan that includes a participant-directed option. For people not yet on Medicaid, Ohio offers limited state-funded supports through Area Agencies on Aging. Veterans can add VA Aid & Attendance or Veteran Directed Care on top of any of these paths.
Programs that pay family caregivers in Ohio
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| PASSPORT Waiver (Medicaid HCBS waiver) | Age 60+, Medicaid-eligible, and meets a nursing-facility level of care. | Funds personal care, homemaking, respite, and adult day services through approved agencies; family members can be hired by participating agencies (spouses excluded). |
| Choices Waiver (Medicaid HCBS waiver) | Same age and clinical eligibility as PASSPORT (60+, nursing-facility level of care, Medicaid-eligible); participant must be able to self-direct (or have a representative). | Consumer-directed alternative to PASSPORT. The participant hires, trains, and supervises their own caregiver — including most family members (spouse excluded). |
| MyCare Ohio (Medicare-Medicaid managed care (select counties)) | Dually eligible adults 18+ in participating counties (Cuyahoga, Franklin, Hamilton, and others) who need long-term services and supports. | Includes a participant-directed option for personal care. Family caregivers (other than spouse) can be hired and paid through the plan’s fiscal intermediary. |
| Ohio Home Care Waiver (Medicaid HCBS waiver) | Adults under 60 with a disability who need a nursing-facility or hospital level of care. | Funds personal care, RN/LPN services, and other home supports; family members can be hired by enrolled provider agencies (spouses excluded). |
| Aid & Attendance Pension (VA benefit) | Wartime veteran or surviving spouse needing help with ADLs and meeting VA income/asset rules. | Increases monthly pension that can be used to pay a family caregiver such as an adult child. Spouse cannot be paid directly. |
| Veteran Directed Care (VDC) (VA program) | Veteran in VA care needing nursing-facility level of care at a participating VAMC. | Self-directed monthly budget that can pay a spouse, adult children, and other family caregivers through a fiscal management service. |
Ohio Medicaid programs
Ohio Medicaid funds family caregivers through three main waivers: PASSPORT and Choices for adults 60+, and the Ohio Home Care Waiver for adults under 60. In participating counties, MyCare Ohio combines these long-term services and supports into a single managed care plan for dually eligible adults.
PASSPORT Waiver
PASSPORT is Ohio’s flagship HCBS waiver for adults 60+ who would otherwise need a nursing facility. Services are delivered by enrolled provider agencies. Family members can apply to work for the chosen agency as the assigned caregiver.
- Eligibility: 60+, Medicaid-eligible, nursing-facility level of care.
- Services: personal care, homemaking, respite, adult day, home-delivered meals, emergency response.
- Family members (other than spouse) can be hired through approved provider agencies.
Choices Waiver
Choices is the consumer-directed companion to PASSPORT. Instead of going through an agency, the participant hires, trains, and schedules their own caregiver and a fiscal intermediary handles payroll.
- Same eligibility as PASSPORT (60+, nursing-facility level of care, Medicaid).
- Participant (or authorized representative) directs care.
- Family caregivers — adult children, grandchildren, siblings — can be paid (spouse excluded).
MyCare Ohio
MyCare Ohio is the integrated Medicare-Medicaid managed care plan available in 29 select counties. The plan includes a participant-directed option that pays family caregivers similarly to Choices.
- Available only in MyCare Ohio counties (e.g., Cuyahoga, Franklin, Hamilton, Lucas, Montgomery).
- Family caregivers can be paid through the participant-directed option (spouse excluded).
State-funded option: AAA Title III and OAA-funded supports
Ohio’s Area Agencies on Aging administer Older Americans Act (OAA) and state-funded programs that supplement Medicaid. These can help families who do not yet qualify for Medicaid pay for limited in-home help.
An AAA care manager assesses needs and offers personal care, homemaker services, respite, and caregiver support through contracted agencies. Cost share may apply.
Family members are most often paid through Medicaid waivers (PASSPORT/Choices) rather than OAA dollars, but caregiver support funds can offset training and respite costs.
Who qualifies
- Ohio residents 60+ (or adults with disabilities served by certain programs).
- Functional needs documented through an AAA assessment.
- Subject to available funding and county priorities.
Veterans’ programs
Ohio veterans and surviving spouses can fund in-home care through two VA pathways: Aid & Attendance and Veteran Directed Care.
Aid & Attendance Pension
A&A increases the monthly VA pension for qualifying wartime veterans (or surviving spouses) who need help with daily living. The benefit is paid to the veteran, who can use it to pay a family caregiver such as an adult child.
- Requires wartime service, limited income/assets, and documented need for daily care.
- Spouses cannot be paid directly through A&A because household income is jointly counted.
Veteran Directed Care (VDC)
VDC gives the veteran a flexible monthly budget to self-direct care. Family — including spouses — can be hired and paid through a fiscal management service.
- Requires veteran to be in VA health care and to need nursing-facility level of care.
- Available at participating Ohio VAMCs (e.g., Cleveland, Cincinnati, Columbus); confirm with the VA social worker.
Long-term care insurance
If the care recipient owns a long-term care insurance policy that covers in-home personal care, benefits may be used to pay a family caregiver.
What to check in the policy
- Confirm in-home personal care is a covered service.
- Cash or indemnity policies let the policyholder pay any caregiver, including family.
- Reimbursement-only policies usually require a licensed home care agency to bill.
If the policy reimburses only licensed agencies, an Ohio-licensed home care agency can employ the family caregiver and bill the insurer for services rendered.
How to apply in Ohio (step-by-step)
- Identify the most likely path: PASSPORT, Choices, MyCare Ohio (in select counties), Ohio Home Care Waiver, VA benefits, or LTC insurance.
- Gather documents: photo ID, Social Security card, proof of income/assets, medical records, medication list, and DD-214 (if applicable).
- Start with the right agency:
- PASSPORT/Choices: contact your local Area Agency on Aging (Ohio Department of Aging, 1-866-243-5678).
- MyCare Ohio: confirm county participation, then enroll through Ohio Medicaid; choose a MyCare plan and request participant-directed services.
- Ohio Home Care Waiver: contact Ohio Department of Medicaid or your case manager.
- VA paths: connect with a VA social worker or VAMC caregiver coordinator.
- Complete the level-of-care assessment and financial review.
- Choose your delivery option (PASSPORT agency or Choices/Participant-Directed self-direction) and enroll your family caregiver with the fiscal intermediary.
- Begin services, submit timesheets, and complete annual reassessments to maintain eligibility.
Ohio paid caregiver FAQs
How do I become a paid caregiver for a family member in Ohio?
The most common path is the Choices Waiver (or the participant-directed option in MyCare Ohio). Your loved one must be Medicaid-eligible and meet a nursing-facility level of care. Once approved, they can hire you and a fiscal intermediary will process payroll. PASSPORT is the agency-based equivalent for people who prefer not to manage their own caregiver.
What is the difference between PASSPORT and Choices?
PASSPORT services are delivered by an agency, while Choices is the consumer-directed version where the participant hires and supervises their own caregiver. Eligibility (age 60+, Medicaid, nursing-facility level of care) is the same.
Can a spouse be paid as a caregiver in Ohio?
Not under PASSPORT, Choices, MyCare Ohio, or the Ohio Home Care Waiver. Spouses can be paid through VA Veteran Directed Care (VDC) at participating Ohio VAMCs.
Where is MyCare Ohio available?
MyCare Ohio operates in 29 counties grouped into seven regions, including Cuyahoga, Franklin, Hamilton, Lucas, Montgomery, Summit, and Stark. Check with Ohio Medicaid for the current county list.
How long does it take to get approved in Ohio?
Most PASSPORT and Choices applications take 45–90 days from the initial assessment to the start of services, depending on documentation and county workload.
