A note from Council on Aging: Council on Aging currently contracts with Aetna Better Health of Ohio and Molina HealthCare of Ohio to manage and coordinate long-term care services for eligible MyCare Ohio members. The announcement below from the Ohio Department of Medicaid (ODM) outlines changes that will occur in the program when Next Generation MyCare begins in January 2026. In COA’s service area, this includes changes to the health plan options available to current members. While some members will need to choose another health plan, no changes will occur until January 2026. MyCare Ohio members will continue to receive services through their current health plan until January 2026. Council on Aging is committed to partnering with ODM and the health plans to create a smooth transition for our members.
The following article was provided by the Ohio Department of Medicaid:
On November 1, the Ohio Department of Medicaid (ODM) announced four managed care organizations to serve as the Next Generation MyCare plans. MyCare Ohio is a managed care program designed for Ohioans who receive both Medicaid and Medicare benefits. MyCare Ohio combines Medicaid and Medicare benefits into one program, coordinated by a managed care plan. This approach to coordinating care keeps the member at the center of focus.
For more than a year, ODM has met with members, providers, and other stakeholders across the state to understand their experiences 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 members to have more choices to meet their healthcare needs. The four Next Generation MyCare plans are:
This announcement does not immediately impact current members and providers of the MyCare Ohio program. Current MyCare Ohio members will continue to receive services with their current MyCare Ohio plan until the Next Generation MyCare plans begin serving members 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 individuals and providers by providing details about expected changes and where to receive help in navigating those changes. ODM, the selected plans, and partner organizations will complete an extensive readiness review process to support a seamless transition to the Next Generation MyCare program.
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 them.
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 a member would like to keep their current plan starting January 2026, no action is required. If a member would like to change their plan, ODM will send out enrollment information in the mail ahead of the 2026 plan year for them to select from one of the Next Generation MyCare plans available. Members can also contact the Ohio Medicaid Consumer Hotline at 800-324-8680 with questions or to select a new plan.
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 them in January 2026. ODM will send out enrollment information in the mail for members to select from one of the Next Generation MyCare plans available. Members 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
ODM modeled the Next Generation MyCare program 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 member and provider experience by:
- Focusing on the individual.
- Improving individual and population wellness and health outcomes.
- Creating a personalized care experience.
- Supporting providers in continuously improving care.
- Improving care for individuals with complex needs to promote independence in the community.
- Increasing program transparency and accountability.
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:
- MyCare Ohio program member frequently asked questions share commonly asked questions by members about the program.
- MyCare Ohio program member one-pager provides you program information, including eligibility information and which plans are available in the counties where MyCare is currently available.
- MyCare Ohio member webpage on medicaid.ohio.gov shares more program resources and is updated regularly to provide the most up to date information.
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.