MyCare Ohio is a system of managed care plans that coordinates the delivery of benefits and services to Ohioans who are eligible for both Medicare and Medicaid. The program is a three year demonstration that covers 29 Ohio counties. MyCare Ohio impacts consumers eligible for Medicare and Medicaid in five Central Ohio counties. Those counties include Delaware, Franklin, Madison, Pickaway, and Union. The program is administered by the Ohio Department of Medicaid (ODM).
The Managed Care Providers (MCO) selected for the Central Ohio region are Aetna Better Health of Ohio and Molina Healthcare. COAAA is working in partnership with Aetna Better Health of Ohio and Molina Healthcare in providing the delivery of services to consumers. If you are already enrolled in a managed care plan, but have questions, call the member services number of your plan. Aetna members can call (855) 364-0974 and Molina members should call (855) 665-4623. If you are not enrolled, call the Medicaid Consumer Hotline at (800) 324-8680 or you can call COAAA at (800) 589-7277 or (614) 645-7250.
If you are a provider for MyCare Ohio members and have questions, call provider relations at each of the plans. Aetna's number is (855) 364-0974 and callers should select option 2 and then option 4. The provider relations number for Molina is (855) 322-4079. If further assistance is needed, providers can call ODM’s Provider Hotline at (800) 686-1516. Also, you can visit the Provider Assistance page from ODM’s website which gives specific information to providers affected by MyCare Ohio.
Rules for MyCare Ohio Plans
- 5160-58-01 MyCare Ohio plans: Definitions
- 5160-58-01.1 MyCare Ohio plans: Application of general managed care rules
- 5160-58-02 MyCare Ohio plans: Eligibility, membership, and automatic renewal of membership
- 5160-58-02.1 MyCare Ohio Plans: Termination of membership
- 5160-58-02.2 MyCare Ohio waiver: Eligibility and enrollment
- 5160-58-03 MyCare Ohio plans: Covered services
- 5160-58-03.2 MyCare Ohio HCBS Waiver Program: Member Choice, Control, Responsibilities, and Participant Direction
- 5160-58-04 MyCare Ohio HCBS Waiver Program: Covered Services and Providers
- 5160-58-05.3 MyCare Ohio waiver: Incident management system
- 5160-58-08.4 Appeals and grievances for MyCare Ohio