50 W. Town Street, Suite 400 Columbus, Ohio 43215 The State of Ohio is an Equal Opportunity Employer and Provider of ADA Services

Medicaid Eligibility Procedure Letter (MEPL) No. 194

Effective Date: March 1, 2026

Issue Date: January 21, 2026

OAC Rules: 5160:1-3-02.1, 5160:1-4-02, 5160:1-4-03, 5160:1-4-04, 5160:1-4-05, 5160:1-5-03, and 5160:1-5-04

To:

Directors, County Departments of Job and Family Services Other Interested Parties

From:

Scott Partika, Director

Subject: Medicaid: 2026 Federal Poverty Level Income Guidelines

Reason for Change: On January 14, 2026, the United States Department of Health and Human Services updated the federal poverty level (FPL) income guidelines. In accordance with Section 1905(p)(2)(D) of the Social Security Act, the annual cost-of- living adjustment (COLA) is deducted from an individual’s countable income for the Medicare Premium Assistance Programs (MPAP) until the annual federal poverty guidelines take effect.

New Policy: The FPL income guidelines for MAGI-Based Medicaid, Medicaid Buy-in for Workers with Disabilities (MBIWD), Ohio WorkAbility, and the Medicare Premium Assistance Programs (MPAP) will be changed effective March 1, 2026.

Action Required: Beginning March 1, 2026, the County Department of Job and Family Services (CDJFS) must determine initial and ongoing eligibility for MAGI-Based Medicaid, MBIWD, Ohio WorkAbility, and MPAP using the following FPL income guidelines:

MAGI-Based Medicaid

2026 Monthly Federal Poverty Level Income Guidelines for MAGI-Based Programs Family Size Individuals Age 19 or 20 44% Parents or Caretaker Relatives 90% MAGI Adults 133% Coverage for Children 156%* Pregnant Women 200% Coverage for Children 206%** 1 $586 $1,197 $1,769 $2,075 $2,660 $2,740 2 $794 $1,623 $2,399 $2,814 $3,607 $3,715 3 $1,002 $2,049 $3,028 $3,552 $4,554 $4,690 4 $1,210 $2,475 $3,658 $4,290 $5,500 $5,665 5 $1,419 $2,901 $4,288 $5,029 $6,447 $6,641 6 $1,627 $3,327 $4,917 $5,767 $7,394 $7,616 *This standard is used for children with creditable insurance. **This standard is used for children without creditable insurance.

Medicaid Buy-in for Workers with Disabilities (MBIWD)/Ohio WorkAbility

Beginning March 1, 2026, the CDJFS must determine initial and ongoing eligibility for the MBIWD/Ohio WorkAbility individual using the updated 250% FPL income guideline below:

Individual Income Guideline 250% $3,325

Medicare Premium Assistance Programs (MPAP)

Beginning March 1, 2026, the CDJFS must determine eligibility for MPAP using the FPL guidelines below:

2026 Monthly Federal Poverty Level Income Guidelines for MPAP Family Size Qualified Medicare Beneficiary (QMB) 100% Specified Low- Income Medicare Beneficiary (SLMB) 120% Qualified Individual-1 (QI-1) 135% Qualified Disabled and Working Individual (QDWI) 200% 1 $1,330 $1,596 $1,796 $2,660 2 $1,804 $2,164 $2,435 $3,607 3 $2,277 $2,732 $3,074 $4,554 4 $2,750 $3,300 $3,713 $5,500 5 $3,224 $3,868 $4,352 $6,447 6 $3,697 $4,436 $4,991 $7,394