Nursing Home/Waiver



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Could I be eligible?

  • Medicaid provides long-term care services for individuals in Nursing Facilities (NFs) and Intermediate Care Facilities for the mentally retarded (ICF-MRs)
  • Home and Community-Based Services Waivers provide home health care to individuals who wish to stay in their home but otherwise need institutional care. The number of consumers that can be enrolled in a waiver program at any one time is limited
  • Income and resources will be evaluated by an Eligibility Referral Specialist

How do I apply?

  • To apply for Medicaid for an individual going into or currently in a Nursing Facility, complete and submit the following application:click here or apply online
  • If you do not have an open Medicaid case, you must complete and submit BOTH of the following applications to apply for Passport/Waiver services (click here -7200 form) (click here -2399 form) If you want someone to apply for you or on your behalf, please complete and submit the Designation of  Authorized Representative form (click here)
  • In person at our agency during regular business hours (M – F 8:00 am-4:00 pm)
  • By dropping a completed application in the agency drop box located in the front of our building, open 24 hours
  • By mailing a completed application 239 W Main Street Lancaster, Ohio 43130
  • By faxing a completed application to 740-689-4848.

What verifications are needed?

  • Proof of citizenship, or alien registration card/I-9
  • Social Security Card
  • Birth Certificate
  • Driver’s License, State ID
  • Proof of all income (employment, child support, disability, unemployment, etc)
  • All resources (bank statements, all life insurance policies, stocks, bonds, annuities, IRA, trusts, and etc )
  • Proof of disability (doctor statement, doctor/hospital records)
  • Social Security award letter (if applicable)

What happens after I submit my application?

  • We offer face to face appointments or phone appointments for you or your Authorized Representative Monday – Friday from 8:00 am – 4:00 pm
  • If you cannot come to an appointment during regular business hours, you can file an application at any time and we will contact you to make other arrangements