Medicare Savings Programs screener for Ohio

What are Ohio's rules?

Ohio calls its Medicare Savings Programs the Medicare Premium Assistance Programs. They are part of Ohio Medicaid and are set out in Ohio Administrative Code rule 5160:1-3-02.1 (effective November 1, 2025). Your county Department of Job and Family Services (JFS) decides eligibility. Ohio looks at two things: your countable income and your countable resources. Ohio uses the federal minimum income levels and keeps an asset test; it hasn't raised the limits as some states have.

Resource limit for all three programs in 2026: $9,950 for one person, $14,910 for a couple. The income limits above include the standard monthly income disregard. Ohio Medicaid's own 2026 eligibility table shows amounts a little lower, because it lists the poverty-level amounts before that disregard is subtracted; the rule is the same. Ohio also has a fourth program, QDWI, which pays the Part A premium for some working people under 65 with disabilities.

How does Ohio count income and savings?

Ohio counts income the way Supplemental Security Income does. If your Part B premium is taken out of your Social Security check, add it back: Ohio counts your income before that deduction, which is why the screener asks for gross income. Income from work is treated more generously: a small part of monthly earnings plus half of the rest doesn't count. That is why the screener tells working people to apply even if they look over the limit. Each January, Ohio sets aside the Social Security cost-of-living increase until the new poverty guidelines are published, so a COLA alone doesn't cost you eligibility early in the year.

For resources, Ohio doesn't count the home you live in, one car used for transportation, money set aside for burial up to a set amount, or life insurance with a small total face value. Bank accounts, certificates of deposit, stocks, bonds, mutual funds and property other than your home generally do count. The county makes the decision; the screener only tells you whether applying is likely to be worth it.

Does Extra Help come with it?

Yes. Everyone who qualifies for QMB, SLMB or QI-1 is treated as eligible for Extra Help, the federal program that lowers Part D premiums, deductibles and copays, without a separate application. If your income or savings are above the premium assistance limits, you may still fit Extra Help: in 2026 its income limit is $23,940 a year for one person ($32,460 for a married couple), and its resource limit is $16,590 for one person or $33,100 for a couple, higher than Ohio's limit. You apply for Extra Help on its own with Social Security. See Extra Help in Ohio and the drug cap estimator.

How do I apply in Ohio?

1. Make sure you have Medicare. If you have never had Part A or Part B, sign up through Social Security first. The county can't start paying premiums until you're enrolled, and it will help if you ask.
2. Apply with Ohio Medicaid. Apply online at benefits.ohio.gov, or at your county Department of Job and Family Services. Questions go to the Ohio Medicaid Consumer Hotline, 1-800-324-8680.
3. Have proof ready. Your Social Security award letter, pension statements (OPERS, STRS Ohio, SERS, OP&F or another plan), recent pay stubs, and bank, life insurance, stock, bond and CD statements, and the deed for any property other than your home.
4. Watch for the decision. The county mails a notice. QMB starts the first day of the month after you're approved, with no retroactive months. SLMB and QI-1 can start up to three months before the month you applied, if you qualified then. Once approved, Ohio Medicaid pays your Part B premium and it stops coming out of your Social Security check after the change goes through.

If Ohio Medicaid pays your Part B premium, some retirement systems stop their own Part B help: SERS, for example, doesn't reimburse Part B when another source, such as Medicaid, pays it. Approval doesn't change your Medicare plan by itself. Premium assistance benefits paid since 2010 aren't subject to Ohio Medicaid estate recovery. If you also get full Ohio Medicaid, read Ohio Medicaid and Medicare, MyCare Ohio and Medicare Savings Programs in Ohio. Late-enrollment penalties are covered on the penalty calculator.

Sources

• Ohio Administrative Code 5160:1-3-02.1 — Medicare premium assistance programs (MPAP), effective November 1, 2025
• Ohio Administrative Code 5160:1-3-03.2 — Medicaid: income exclusions
• Ohio Administrative Code 5160:1-3-05.13 — Medicaid: treatment of the home
• Ohio Administrative Code 5160:1-3-05.11 — Medicaid: automobiles as resources
• Ohio Administrative Code 5160:1-2-07 — Medicaid estate recovery
• Ohio Department of Medicaid — 2026 Monthly Financial Eligibility, Aged, Blind or Disabled Individuals (PDF)
• Ohio Benefits — Apply for Medicaid
• Medicare.gov — Medicare Savings Programs (2026 income limits)
• Social Security — Extra Help with Medicare prescription drug costs
• SERS — 2027 Member Health Care Guide (Part B reimbursement) (PDF)

Frequently asked questions