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Ohio Department of Medicaid · November 1, 2024 · Primary source

Ohio Medicaid Announces MyCare Ohio Plans Chosen to Serve Ohioans in Next Generation Program Four managed care plans selected to serve Ohioans eligible for Medicaid and Medicare. November 01, 2024

Score 70PRIMARYregulatoryState MedicaidOH

Summary

Ohio Medicaid selected four managed care organizations, Anthem Blue Cross and Blue Shield, Buckeye Health Plan, CareSource, and Molina HealthCare of Ohio, to serve as Next Generation MyCare plans for Ohioans dually eligible for Medicare and Medicaid beginning January 2026. The program will initially operate in the existing 29 MyCare Ohio counties before expanding statewide, covering an estimated 250,000 eligible Ohioans. The new contracts include enhanced requirements around behavioral health services, transportation, self-direction, and long-term care, developed through a year of stakeholder engagement.

What this may mean

The four selected plans will assume comprehensive dual-eligible care coordination obligations under a revised contract beginning January 2026, with the new contract terms creating updated compliance, credentialing, and network adequacy obligations relative to the current MyCare Ohio demonstration. Current MyCare Ohio plans and providers continue operations unchanged until the January 2026 transition, after which provider contracts and care coordination arrangements transfer to the four selected plans. Plans not selected, and their current provider networks, face transition risk as the program moves to the new plan structure.

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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