MyCare Ohio is a managed care program for Ohioans who receive both Medicare and Medicaid benefits. The program is administered by the Ohio Department of Medicaid (ODM). We have a MyCare ombudsman dedicated to answering your questions and helping you navigate this program in Southwest Ohio. Find MyCare Ohio information for your county.
Please contact our ombudsman LeVon at 513-458-5536 about MyCare Ohio. Learn more about LeVon here.
Learn more about the MyCare Ohio Ombudsman role and hear from caregivers who have worked with LeVon to resolve concerns in these brief videos on our YouTube channel.
This brochure or the following description of MyCare Ohio from the Ohio Department of Medicaid may also help.
How does MyCare Ohio Work?
• Approved MyCare Ohio Plans provide integrated benefits to Medicare and Medicaid enrollees in seven regions in Ohio.
• Plans include all standard benefits available through traditional Medicare and Medicaid programs, including: (1) Doctor and hospital visit, (2) Mental health services, and (3) Long-term care services provided in nursing, assisted living facilities or in the home (via services such as home-delivered meals, medical transportation, and help with personal care).
• Single identification card issued by selected plan to access services.
Who is Eligible?
• Age 18 and older at the time of enrollment; and
• Eligible for full Medicare Parts A, B, and D and full Medicaid; and
• Reside in a MyCare Ohio Demonstration Region. This includes Southwest Ohio: Butler, Clermont, Clinton, Hamilton, Warren counties.
Who is Not Eligible?
• Individuals under the age of 18
• Individuals with a delayed Medicaid spend-down
• Individuals who have other third party creditable health care coverage
• Certain individuals with Intellectual Disabilities and other Developmental Disabilities
• Individuals enrolled in an Ohio PACE program.
MyCare Ohio Health Plans
In Southwest Ohio (Butler, Clermont, Clinton, Hamilton and Warren Counties), you have two MyCare Ohio Health plans to choose from:
These health plans have contracts with the Ohio Department of Medicaid to operate in a five county region as part of the new MyCare Ohio system.
Enrollment and Disenrollment
• Participation in MyCare Ohio is voluntary for the Medicare portion.
• Individuals can opt-out of the Medicare portion at any time.
• Individuals can also transfer between MyCare Ohio Plans if they opt-in to Medicare on a month-to-month basis.