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The Next Generation MyCare program is an improved healthcare program for Ohioans who have both Medicaid and Medicare. This program helps members get the care they need all in one plan. Starting January 1, 2026, the Ohio Department of Medicaid (ODM) changed the MyCare Ohio program to give members the best care possible. These changes include:
- More support for members to receive the care they need through a care team.
- Better transportation options to get members to and from their appointments.
- More in-home providers available to members.
- Shorter wait time for prior authorizations.
How can members select a Next Generation MyCare plan?
ODM selected four Next Generation MyCare plans. Three of the plans are available for members to select statewide. The plans include some current MyCare Ohio plans and a new plan to the program. All plans will cover a member’s Medicare and Medicaid benefits.
The Next Generation MyCare plans available statewide are:
Buckeye Health Plan won't be an option for new members or for those currently receiving care through another MyCare Ohio plan starting in the 2026 plan year. If a member receives care through Buckeye Health Plan today and wants to keep their plan, no action is required.
During Medicaid or Medicare open enrollment, members can pick Anthem Blue Cross and Blue Shield, CareSource, or Molina HealthCare of Ohio as their Next Generation MyCare plan.
- Each year Medicaid open enrollment is from November 1 to November 30. Members can call the Ohio Medicaid Consumer Hotline at 800-324-8680.
- Each year Medicare open enrollment is from October 15 to December 7. Members can call Medicare at 800-633-4227.
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What do members need to do ahead of the Next Generation MyCare Program?
The steps members need to take depends on how they get care today. Visit the MyCare Ohio webpage on medicaid.ohio.gov or keep reading to find what scenario best describes them and what steps they need to take.
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If the member lives in a MyCare Ohio county and they get care through Buckeye Health Plan, CareSource, or Molina HealthCare of Ohio:
- If the member wants to keep their plan, no action is needed. If the member wants a different plan, they can switch during open enrollment.
- The member’s Next Generation MyCare benefits will begin January 1, 2026. They will receive information from their plan before the Next Generation MyCare program is available.
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If the member lives in a MyCare Ohio county and they get care through Aetna Better Health of Ohio or United Healthcare Community Plan, their plan will not be a MyCare plan after December 31, 2025.
- Members can pick a different plan during open enrollment. If they do not pick a different plan, they will be automatically enrolled in a Next Generation MyCare plan for their Medicaid benefits. The member’s new plan will have as many of their current doctors as possible.
- Members will not lose coverage due to this change. They will get more information about what this change means for them. The member’s Next Generation MyCare plan and benefits start on January 1, 2026. They will receive information from ODM about their new plan and options before the Next Generation MyCare program is available.
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If the member lives in a current MyCare Ohio county and will become eligible for the MyCare Ohio program before January 1, 2026, they will:
- Get their Medicaid benefits through fee-for-service until their Next Generation MyCare coverage starts. Members will also get a letter from ODM between October and December of 2025 that tells them their Next Generation MyCare plan, when their coverage starts, and options to change their plan or align their Medicare and Medicaid coverage.
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If the member becomes eligible for the Next Generation MyCare program after January 1, 2026, and lives in a county where MyCare is not currently available:
- When the Next Generation MyCare program is available in their county, the member will get a letter from ODM that gives them information about their Next Generation MyCare plan, when their Next Generation MyCare plan starts, and options to change their plan or align their Medicare and Medicaid plan.
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Where can members learn more about the Next Generation program?
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The Next Generation MyCare program will start on January 1, 2026. It will be available in the 29 counties where MyCare Ohio is available today. Later in 2026, it will be available in the rest of Ohio.
When the Next Generation MyCare program is available in the member’s county, they will receive a new Next Generation MyCare member identification (ID) card in the mail from their Next Generation MyCare plan to use at their appointments. The member ID card includes important information about their plan, doctors, and who to contact for help in one place.
If the member has a MyCare Ohio plan for both their Medicaid and Medicare benefits, they will have one member ID card to be used at their appointments. If the member’s MyCare Ohio plan only covers their Medicaid benefits, they will have up to three cards for their benefits.
If a member needs to replace their ID card, they should call their plan’s member services department, or sign up with their plan in the member services portal. Members can print a copy of their ID card at any time from their plan portal. If the member orders a card by telephone, it should arrive in the mail in 7-10 business days from the date of their request.
Next Generation MyCare plan phone numbers:
Read the Next Generation MyCare Member ID Card One Pager to see the card template.
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As we are preparing for the implementation of the Next Generation MyCare program on January 1, 2026, we are engaging with members, providers, advocates, and others to share information about the program and hear from them. Since April 2025, we attended four community visits and hosted five MyCare Ohio Advisory Workgroup meetings. The input we get during these meetings and events is used to support our implementation of the program, including how we communicate about Next Generation MyCare.
Help us continue to receive feedback to improve the Next Generation MyCare program by sharing information about upcoming community visits and advisory workgroup meetings as you interact with stakeholders. Visit the MyCare Ohio members webpage on medicaid.ohio.gov to view the schedule of upcoming community visits. Visit MyCare Ohio stakeholders webpage to learn more about the Advisory Workgroup.
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