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Ohio Department of Medicaid "MyCare Ohio" November 2014 Provider Update


MyCare Ohio has been implemented in seven geographic regions composed of 29 Ohio counties. Beneficiaries in each of those counties have already selected a managed care plan and are enrolled as “Medicaid Only” members for the Medicaid portion of their MyCare Ohio benefit. Some beneficiaries have already elected to enroll as “Dual Benefits” members and are receiving their Medicare benefit from the same MyCare Ohio plan that provides their Medicaid coverage.

If a beneficiary does not select an alternative for their Medicare benefit by December 31, 2014, the beneficiary will be automatically enrolled in their current Medicaid MyCare Ohio plan for the administration of Medicare benefits. This will ensure continuous availability of coverage and services for both programs. This coverage will begin on January 1, 2015.

All beneficiaries have the ability to opt-out of the Medicare portion of the MyCare Ohio program. Those choosing to do so will continue to receive Medicaid coverage through the MyCare Ohio managed care plan. However, the delivery of their Medicare benefits will remain unchanged.

Provider Impact & Options:

There is a transition period of up to one year for physicians who do not have a relationship with a patient’s MyCare Ohio plan. During that transition, physicians may continue to serve patients who are members of MyCare Ohio managed care plans. We hope this will lead to the eventual establishment of a contractual relationship between the provider and the MyCare Ohio plan to maintain continuity of care throughout the demonstration. MyCare Ohio plan networks are also open to new physician contracts.

Additional information on transition requirements for physicians and other provider types can be found in the MyCare Ohio Plan Payment Requirements document online:

Please contact the plans’ provider services hotlines with questions:
AETNA (855) 364-0974
BUCKEYE (866) 296-8731
CARESOURCE (800) 488-0134
MOLINA (855) 322-4079
UNITED HEALTHCARE (800) 600-9007

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