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The Ohio Department of Medicaid (ODM) has been conducting MyCare Ohio program community input sessions across the state. During these sessions, we have been meeting with members, providers, and others to hear their experiences with healthcare and the providers who serve them and share the exciting changes coming to the program. From these sessions, we learned that there is confusion about the transition to the Next Generation MyCare program. The MyCare Ohio program is not going away, only improving. Read the below questions and answers to learn more about the program and its future.
What is MyCare Ohio?
MyCare Ohio is a managed care program designed for Ohioans who receive BOTH Medicaid and Medicare benefits. This program has a team approach to coordinating your care based on your needs – a team with you at the center.
The MyCare Ohio plan that you choose provides all the same benefits that Medicare and Medicaid offer, including long-term care services and behavioral health services. Plus, your MyCare Ohio plan may include additional services to you.
You have two choices for receiving your MyCare Ohio benefits:
- Dual benefits: A MyCare Ohio plan provides both your Medicare and Medicaid benefits. You are eligible to receive added benefits the plan might offer, like $0 copayments for prescription drugs covered by Medicare and additional transportation services.
- Medicaid-Only Benefits: A MyCare Ohio plan only covers Medicaid-covered services. You will continue to receive prescription drugs through your Part D plan and any associated co-payments. Your Medicare benefits would be provided through traditional Medicare or through a private insurance company, commonly referred to as a “Part C” plan.
Is the MyCare Ohio program going away?
No, MyCare Ohio is not going away.
To better serve Ohioans who are dually eligible, ODM will be launching its Next Generation MyCare program in January 2026 for the 29 counties where MyCare Ohio is currently available. Statewide expansion will follow as expeditiously as possible.
The Next Generation MyCare program aims to improve member and provider experience by:
- Focus on the individual.
- Improve individual and population wellness and health outcomes.
- Create a personalized care experience.
- Support providers in continuously improving care.
- Improve care for individuals with complex needs to promote independence in the community.
- Increase program transparency and accountability.
What is the current status of the Next Generation MyCare procurement?
Earlier this year, ODM conducted a Request for Applications (RFA) that was intended for managed care organizations interested in becoming Next Generation MyCare plans for Ohioans who are dually eligible for Medicaid and Medicare.
As a next step in this process, ODM is reviewing the responses to the RFA we received and plans to award new MyCare contracts in the fall. The selected plans will be an essential piece in improving the health and lives of Ohioans.
Where do I go to learn more about MyCare Ohio or ask questions?
If you are a MyCare Ohio member and have questions about your services, contact the member services number on your plan’s ID card. If you cannot locate the number, call the Ohio Medicaid Consumer Hotline at 800-324-8680.
If you are enrolled in a Medicaid waiver program (like PASSPORT or Assisted Living), and have questions about your services or providers, please contact your case manager. If you can’t locate the number, call the Area Agency on Aging at 866-243-5678.
Find additional information, including frequently asked questions about the MyCare Ohio program, visit the MyCare Ohio program member frequently asked questions document on the MyCare Ohio webpage on https://medicaid.ohio.gov/.
On Wednesday, August 7, the Next Generation MyCare Request for Applications (RFA) response period closed. The Next Generation MyCare program aims to improve your healthcare experience. MyCare Ohio is a managed care program designed to coordinate care for Ohioans who receive both Medicaid and Medicare benefits. Through the program, MyCare Ohio members will receive all their medical, behavioral, and long-term services and supports. As the next steps in this process, Ohio Department of Medicaid will review the responses to the RFA and plans to award new MyCare contracts in the fall. Check out our newest micro video “Next Generation MyCare Request for Applications next steps” to learn more.
 At this point in time, ODM is in the “quiet period” for the Next Generation MyCare procurement, which dramatically limits the information available to share on an individual basis. All information ODM releases regarding the Next Generation MyCare procurement must be at equal opportunity of access for potential bidders, preventing any compromise of the procurement.
It is ODM’s commitment to remain as communicative and transparent as possible through the remainder of the procurement process, while still maintaining the integrity of the Next Generation MyCare procurement. ODM will not be able to answer questions from members of the public or potential bidders regarding the Next Generation MyCare program, but general updates and announcements will be posted on the MyCare Ohio webpage on Medicaid.ohio.gov.
Resources on procurement regulations can be found in the State of Ohio Procurement Manual.
For additional information about the RFA or procurement process, visit the MyCare Ohio webpage on Medicaid.ohio.gov.
Return to Top
MyCare Ohio is an Ohio Department of Medicaid managed care program designed for Ohioans who receive both Medicaid and Medicare benefits. This program coordinates care for your medical, behavioral health, and long-term services and supports.
To learn more about the MyCare Ohio program, check out our two new MyCare Ohio micro videos.
Our “What is MyCare Ohio?” micro video shares an overview about the program, including eligibility and enrollment.
 Our “MyCare Ohio program benefits” micro video provides information about a member’s enrollment options and the benefits they receive from the MyCare Ohio program upon enrollment.
 Find additional information, including more resources, about MyCare Ohio program on the MyCare Ohio webpage on medicaid.ohio.gov.
OhioRISE and the specialized managed care program is making major strides in supporting more youth and families in need.
More Ohio children than ever are being supported through a program that coordinates community resources to provide the best possible care for kids facing complex mental and behavioral health needs.
July marked two years since Ohio’s launch of OhioRISE and the specialized managed care program is making major strides in supporting more youth and families in need. In that time, OhioRISE increased its capacity to serve more than six times the children than it did on day one, expanded its network across the state, and continues to add new types of available services and supports.
OhioRISE Growth — By the Numbers
- Grew from 5,500 children enrolled on day one to 37,748 children and youth served today
- Serves more than 3,800 kids in foster care
- Added 800 new care coordinators in all 88 Ohio counties since inception
- Employs nearly 4,000 program eligibility assessors
To read the full article, click here.
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