Ohio Medicaid for Seniors: How PASSPORT and PACE Help Dayton Families Stay Home

The phone call usually sounds the same. A daughter in Kettering, a father in Huber Heights who fell again last month, and a question underneath everything else: does he have to go into a nursing home?

Often the answer is no — and the reason is two Ohio Medicaid programs that a lot of Miami Valley families have never heard of. They work very differently, and one of them just arrived in our part of the state.

Two Programs, Two Doors

PASSPORT and PACE both exist to do the same thing: keep someone who qualifies for nursing home care living at home instead. They go about it in opposite ways.

PASSPORT is a Medicaid waiver. You keep your own doctors, and the program brings services into your house — an aide, meals, a shower bar, a ride to the cardiologist. A case manager builds the package around what you need.

PACE replaces your coverage entirely. One organization becomes your doctor, your hospital plan, your drug plan, your therapy, your transportation, and your day center, all coordinated by a single team.

Neither is better. They fit different people, and one of them may not be available where you live.

PASSPORT: Help That Comes to Your House

Ohio’s PASSPORT program has been running for decades, and it’s the more common path in the Dayton area. It works in two stages.

First is a pre-admission screening, done over the phone. Staff figure out whether you’re likely to qualify for Medicaid and how much care you actually need. They’ll also walk through your other long-term care options, which is genuinely useful even if PASSPORT turns out not to be the fit.

Second is the home care itself. Once someone is found eligible, a case manager builds a service plan from local providers and checks in regularly to make sure the care meets standards. Services available through PASSPORT include:

• Personal care, homemaker, and chore services
• Home delivered meals and nutritional counseling
• Adult day care and independent living assistance
• Minor home modifications — grab bars, ramps, the practical things
• Emergency response systems
• Medical equipment and supplies
• Social work counseling and medical transportation
• Waiver nursing and out-of-home respite

Ohio added Structured Family Caregiving to PASSPORT in October 2024. Under it, an agency provider can employ or contract a caregiver who lives with the person to provide daily care and support. For families where a son or daughter has already quietly become the full-time caregiver, that’s a meaningful change — it puts a structure and a provider relationship around work that was happening anyway.

PASSPORT participants also get a Medicaid card, which covers physician care, hospitalization, and prescription drugs alongside the waiver services.

Who Qualifies for PASSPORT

The Ohio Department of Aging lists four requirements. A participant must be:

• Age 60 or older
• Financially eligible for Medicaid institutional care
• Frail enough to require a nursing home level of care
• Able to remain safely at home, with their physician’s consent

On the financial test, be careful with the numbers you find online — including the ones the state itself publishes. Ohio’s PASSPORT eligibility page currently illustrates the limits using 2024 figures: roughly $2,829 per month in income for one person, and no more than $2,000 in countable assets. Those income limits are adjusted over time, so treat the monthly figure as an illustration of the ballpark rather than this year’s number, and confirm the current threshold before you rule anyone out.

That last point matters more than it sounds. The state’s own page notes that people above the limit may still be eligible depending on the extent of their medical and in-home needs. Families disqualify themselves on paper all the time without ever making the call.

Applications run through your county Department of Job and Family Services, and the PASSPORT Administrative Agency for your area handles the screening. In Greene and Montgomery counties, that’s the regional Area Agency on Aging. Ohio’s Department of Aging maintains a lookup tool for finding yours.

PACE: One Team for Everything

PACE — the Program of All-Inclusive Care for the Elderly — takes a different approach. Instead of adding services around your existing coverage, PACE becomes the coverage.

A PACE organization provides primary and specialty care, prescription drugs, hospital care, nursing home care when it’s needed, physical and occupational therapy, dentistry, eye care, foot care, mental health counseling, personal care, meals, adult day health services, and transportation to and from appointments. An interdisciplinary team decides together what you need and then delivers it.

You can join PACE if you meet four conditions: you’re at least 55, you live in a PACE organization’s service area, you need a nursing home level of care as certified by the state, and you can live safely in the community with PACE’s help.

The cost structure is unusual. If you have Medicaid, you pay no monthly premium for PACE. If you have Medicare but don’t qualify for Medicaid, you pay a monthly premium for the long-term care portion plus a premium for Part D drugs. And here’s the part that surprises people: regardless of your financial situation, there is no deductible, copayment, or coinsurance for any drug, service, or care your PACE team approves. Compared with Original Medicare’s open-ended 20% coinsurance, that’s a very different risk profile.

The trade-off is real, though. You use the PACE team. If you’re deeply attached to a physician you’ve seen for twenty years, PACE will feel like a loss.

PACE Is Arriving in Montgomery County

For years, PACE simply wasn’t an option here. It operated in Cuyahoga, Franklin, Hamilton, Summit, Lorain, Mahoning, Trumbull, and Ashtabula counties — Cleveland, Columbus, Cincinnati, Akron, Youngstown. Not Dayton.

That’s changing. Ohio’s PACE rollout chart lists BoldAge PACE in Montgomery County with a tentative go-live of July 2026, with Lucas County following in December 2026. As of this writing, the state’s chart still showed Montgomery as a scheduled opening rather than “Active,” so the practical advice is to call and confirm whether they’re accepting enrollments yet rather than assume either way.

Two things Miami Valley families should note. First, Greene County is not on the state’s rollout chart — so a Beavercreek or Xenia resident should ask specifically whether their address falls inside the service area, because PACE eligibility is tied to geography. Second, PACE starts at 55, not 60 or 65. It’s the rare long-term care program that can help someone who is still years away from Medicare.

The Part D Mistake That Undoes Everything

This one deserves its own warning. If you have Medicare and join PACE, you get your Part D drugs and all other medication through PACE. If you then enroll in a separate Medicare drug plan, you’ll be disenrolled from PACE.

Picture how easily that happens. Annual Enrollment rolls around in the fall, a well-meaning mailer arrives promising lower drug costs, an adult child helps mom sign up for a standalone Part D plan — and the entire PACE arrangement collapses. Anyone in PACE, and every family member who helps them with paperwork, needs to know this before October.

Estate Recovery: The Part Families Don’t See Coming

Medicaid long-term care is not a gift, and this is where planning matters.

Some costs the state pays for PASSPORT care are subject to estate recovery. Under federal law and Section 5111.11 of the Ohio Revised Code, all Medicaid services provided to a person age 55 or older are subject to recovery — physician visits, outpatient visits, home- and community-based waiver services like PASSPORT, and other medically related Medicaid services. After death, the state can pursue the estate for what it spent.

For many families the house is the estate. That doesn’t make PASSPORT the wrong choice — care your parent needs today usually outweighs an inheritance tomorrow — but it should be a decision made with open eyes rather than discovered by an executor eighteen months later. Your county Department of Job and Family Services can explain how recovery works in a specific situation, and this is a reasonable moment to involve an elder law attorney.

Where to Start

If you’re watching a parent in Beavercreek or Centerville slowly lose ground, the PASSPORT pre-admission screening is a low-cost first step — it’s a phone call, and the staff will lay out the options whether or not you end up qualifying. If your parent is in Montgomery County and needs comprehensive coordination, PACE is worth a call once it’s confirmed open.

And if you’re trying to see how any of this fits with Medicare coverage, a Medigap policy, or a long-term care plan you already own, that’s the conversation we have most often. Medicare & Retirement Solutions Group is in Beavercreek, we work with families across Greene and Montgomery counties, and a consultation costs nothing. Call us, or reach out at medretiregroup.com, and we’ll help you figure out which door to knock on first.

This article is general educational information, not individualized tax, insurance, or investment advice. Rules and figures change and individual circumstances vary — please confirm details with your plan, or speak with a qualified professional, before acting.