On November 1, the Ohio Department of Medicaid (ODM) announced four managed care organizations that will serve as the Next Generation MyCare plans. MyCare Ohio is a managed care program designed for Ohioans who receive both Medicaid and Medicare benefits. The MyCare Ohio program combines Medicaid and Medicare benefits into one program, coordinated by a managed care plan.
Below is the full announcement from ODM:
For more than a year, ODM has met with members across the state to understand your experience with the MyCare Ohio program. This feedback will inform ODM and the newly selected plans as they work together to implement a better person-centered experience for Ohioans across the state. ODM’s announcement and additional information can be found in the press release.
ODM awarded four managed care organizations as ODM’s Next Generation MyCare plans. The selected plans include a continued partnership of some of the MyCare Ohio plans who have served MyCare Ohio members in the current demonstration as well as the addition of new plans that have served in the Next Generation managed care program to allow you to have more choices to meet your healthcare needs. The four Next Generation MyCare plans are:
This announcement does not immediately impact current members of the MyCare Ohio program. You will continue to receive services with your current MyCare Ohio plan until the Next Generation MyCare plans begin serving you in January 2026 and will not lose coverage.
Starting in January 2026, the selected plans will support Ohioans who are dually eligible for both Medicare and Medicaid healthcare coverage in the 29 counties where MyCare Ohio is currently available, with statewide expansion following as quickly as possible. Before January 2026, ODM will support you by providing details about expected changes and where to receive help in navigating those changes.
Prior to the Next Generation MyCare plans beginning in January 2026, MyCare Ohio members in the 29 counties where MyCare Ohio is currently available will have the opportunity to select from the plans available to you.
MyCare Ohio members enrolled in Buckeye Health Plan, CareSource, or Molina HealthCare of Ohio
MyCare Ohio members enrolled in Buckeye Health Plan, CareSource, or Molina HealthCare of Ohio will continue to receive services through that plan until January 2026. If you would like to keep your current plan starting January 2026, no action is required. If you would like to change your plan, ODM will send out enrollment information in the mail ahead of the 2026 plan year for you to select from one of the Next Generation MyCare plans available.
MyCare Ohio members enrolled in Aetna Better Health of Ohio or United Healthcare Community Plan
MyCare Ohio members currently enrolled in Aetna Better Health of Ohio or United Healthcare Community Plan will continue to receive services through that plan until January 2026, but will need to select a Next Generation MyCare plan to begin serving you in January 2026. ODM will send out enrollment information in the mail for you to select from one of the Next Generation MyCare plans available. You can also contact the Ohio Medicaid Consumer Hotline at 800-324-8680 with questions or to select a new plan.
Next Generation MyCare program goals
The Next Generation MyCare program is modeled after the Next Generation managed care program, which focuses on the individual rather than the business of managed care. The Next Generation MyCare program aims to improve your experience by:
This is a new vision for Ohio's MyCare program - one that focuses on the healthcare needs of Ohioans who are dually eligible. We look forward to continuing to work with you and hearing from you as we work together to better serve dually eligible Ohioans.
To learn more about the Next Generation MyCare program refer to the resources below:
If you have questions about the Next Generation MyCare program, contact the Ohio Medicaid Consumer Hotline at https://www.ohiomh.com/ or call 800-324-8680. Representatives are available Monday through Friday 7 a.m. to 8 p.m. Eastern time (ET) and Saturday 8 a.m. to 5 p.m. ET.
If you have feedback about the Next Generation MyCare program, please contact MyCareConversionQuestions@medicaid.ohio.gov.