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Ohio Department of Medicaid · May 31, 2024 · Primary source

Ohio Medicaid to Expand Program Designed to Strengthen Independent Living Request for Applications now open for Next Generation MyCare program. May 31, 2024

Score 68PRIMARYregulatoryState MedicaidOH

Summary

Ohio Medicaid issued a Request for Applications for managed care plans to participate in the Next Generation MyCare program, an expanded dual-eligible demonstration covering Ohioans eligible for both Medicare and Medicaid. The program, currently available in 29 counties and serving approximately 150,000 members, is scheduled to expand statewide with a January 2026 launch date. Plans were required to notify ODM of intent to apply by June 21, 2024, with final applications due by August 2, 2024.

What this may mean

Managed care organizations seeking to participate in Next Generation MyCare must demonstrate experience managing dual-eligible populations across both Medicare and Medicaid benefit structures, including long-term services and supports. The January 2026 launch triggers new contractual obligations for selected plans covering an estimated 250,000 eligible Ohioans statewide, with program design changes including a focus on behavioral health, transportation, and self-direction services. Plans currently serving MyCare Ohio members continue under existing contracts until the January 2026 transition.

Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.

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