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The Next Generation MyCare program starts next month, 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.
As the Ohio Department of Medicaid (ODM) prepares for the program, we want to share how we see you supporting members and providers. Keep reading to learn more or visit the MyCare Ohio stakeholder webpage.
How does this change impact AAA staff?
AAAs are partnering with the Next Generation MyCare plans to support members in getting the care they need. The plan and AAA delegation model determine how you work together to serve members.
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Full Delegation: AAAs serve as a member’s waiver service and care coordinator.
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Partial Delegation: AAAs or the plan may serve as a member’s waiver service coordinator or care coordinator.
View the Next Generation MyCare Care Coordination One-Pager to learn more.
How does this change impact members and what should I share with them?
On January 1, 2026, members who live in a MyCare Ohio county will get their care through a Next Generation MyCare plan. Members will receive a welcome packet with information about their plan and their new member ID card to be used at their appointments. Check out our Next Generation MyCare Member ID Card One-Pager to learn more.
If a member has questions about their plan or benefits, direct them to the Ohio Medicaid Consumer Hotline at 800-324-8680 or www.ohiomh.com. Representatives are available Monday through Friday 7 a.m. – 8 a.m. and Saturdays 8 a.m. – 5 p.m. Eastern time.
As you interact with members and advocates, we encourage you to spread the word about the changes coming and share the Next Generation MyCare Member Frequently Asked Questions (FAQ) and Next Generation MyCare Member Help Desk One-Pager to help members learn more and know where to go for help.
How does this change impact providers and what should I share with them?
To provide services in the program, providers must enroll with ODM if they have not already done so and contract with the Next Generation MyCare plans. Refer to the Credentialing Guide and Requirements Document for more information.
Additionally, the way they submit Electronic Data Interchange (EDI) claims for Next Generation MyCare members is changing. EDI claims will now come through the Ohio Medicaid Enterprise System (OMES) one front door. Refer to the Companion Guides for more information.
If a provider has questions, they should contact the ODM Integrated Helpdesk at 800-686-1516 or IHD@medicaid.ohio.gov. Representatives are available Monday through Friday, 8 a.m. - 4:30 p.m. Eastern Time.
As you interact with providers or providers advocacy groups, we encourage you to spread the word about the changes coming and share the Next Generation MyCare Program Provider FAQ and Next Generation MyCare Provider Help Desk One-Pager to help providers learn more and know where to go for help.
Thank you for supporting ODM as we get ready for the Next Generation MyCare program.
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