MedicaidCoverageMedium impact
5160:1-6-04 - Medicaid: treatment of income and resources for an institutionalized spouse with a spouse in the community. (Amend/Final File)
Ohio Medicaid·OH · Geriatrics, Internal Medicine, Family Medicine·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Ohio Medicaid updated Rule 5160:1-6-04 regarding income and resource treatment for institutionalized spouses with community-dwelling spouses. This affects Medicaid eligibility determinations for patients in long-term care facilities whose spouses remain at home.
Action Required
Before April 1, 2026: Billing teams working with Ohio Medicaid patients in long-term care should review updated spousal impoverishment rules for eligibility verification. Contact Ohio Department of Medicaid at 614-752-3877 for clarification on income and resource calculations affecting patient coverage status.