Because Ohio uses a Special Income Level model instead of an unlimited spend-down, planning conversations here look different from states with open-ended income rules. The 2026 individual SIL of $2,982 per month is the number that determines whether someone needs additional planning tools just to qualify.
For income that exceeds that threshold, Ohio permits a Qualified Income Trust — often called a Miller Trust — as a regulatory workaround. It's a narrow, technical tool built to satisfy Ohio's specific income-eligibility rules, not a substitute for a comprehensive financial plan that also accounts for transfer timing, estate recovery exposure, and available insurance.
A complete Ohio plan typically weighs the state's expanded estate-recovery reach, the 60-month look-back window, the mechanics of the Transfer on Death Designation Affidavit, and whether a Partnership-qualified long-term-care insurance policy makes sense given the family's timeline.