What changed on January 1, 2026
Ohio's original MyCare Ohio program was a federally approved Medicare-Medicaid Plan (MMP) demonstration that began in 2014 in 29 counties. Under that model, plans coordinated Medicare and Medicaid benefits but operated under a hybrid set of rules that limited some efficiencies. After more than a decade of experience, Ohio chose to transition to a permanent, fully integrated structure.
On January 1, 2026, the demonstration ended. Next Generation MyCare Ohio launched in its place as a Fully Integrated Dual-Eligible Special Needs Plan (FIDE-SNP). The key differences:
- One plan, one card. Members receive a single FIDE-SNP plan that handles both Medicare and Medicaid benefits, instead of holding a separate Medicaid card or relying on coordination between two plans.
- Statewide expansion. MyCare Ohio was limited to 29 counties for over a decade. Next Generation MyCare is rolling out to all 88 Ohio counties between January and August 2026.
- FIDE-SNP federal model. The legal structure is now standardized under federal SNP rules rather than a state-specific demonstration waiver, giving members more predictable rights and protections.
- Coordination-only D-SNPs eliminated. CO-DSNPs that previously offered separate Medicare with Medicaid coordination but no integrated benefits are no longer permitted in Ohio.
The four FIDE-SNP plans
After the Ohio Department of Medicaid (ODM) issued a competitive Request for Applications, four managed care organizations were selected to operate Next Generation MyCare plans starting January 1, 2026:
| MCO | Parent company | Ohio market presence |
|---|---|---|
| Anthem Blue Cross and Blue Shield | Elevance Health | Major statewide Medicaid and Medicare presence |
| Buckeye Health Plan | Centene | Long-standing Ohio Medicaid MCO |
| CareSource | CareSource (Dayton-based) | Ohio-headquartered, largest Medicaid MCO in Ohio |
| Molina HealthCare of Ohio | Molina Healthcare | Significant Medicaid managed care experience |
All four MCOs are required to provide the full Medicare and Medicaid benefit packages plus enhanced supplemental benefits typical of D-SNP plans — care coordination, transportation, dental, vision, hearing, OTC allowances, and behavioral health integration. The specific benefit packages and provider networks vary, and that's the basis on which eligible members compare and choose.
Statewide rollout schedule
Next Generation MyCare Ohio rolls out in phases throughout 2026. The schedule, as published by ODM and the four MCOs:
| Effective date | Counties added |
|---|---|
| January 1, 2026 | Original 29 MyCare counties (continued from the demonstration) |
| April 1, 2026 | Sandusky, Erie, Henry, Williams, Defiance, Paulding, Fayette, Fairfield, Licking, Ashtabula |
| May 1, 2026 | Preble, Darke, Miami, Shelby, Champaign, Logan, Van Wert, Putnam, Hancock, Allen, Mercer, Auglaize, Hardin, Seneca, Huron, Wyandot, Crawford, Richland, Ashland, Marion, Morrow |
| June 1, 2026 | Ross, Vinton, Highland, Pike, Jackson, Gallia, Brown, Adams, Scioto, Lawrence |
| July 1, 2026 | Holmes, Tuscarawas, Carroll, Jefferson, Coshocton, Harrison, Belmont, Guernsey, Muskingum |
| August 1, 2026 | Hocking, Perry, Morgan, Noble, Monroe, Washington, Athens, Meigs, and any remaining counties — statewide complete |
If you live in a county that hasn't yet transitioned, your current Medicare-Medicaid coordination continues until your county's effective date. You'll receive notice from ODM and from your MCO before the change, with information about plan options and the choice period.
If you live in Holmes, Tuscarawas, or one of the Appalachian counties
Many of Ohio's Amish and Mennonite communities — concentrated in Holmes, Wayne, and Tuscarawas counties — have religious exemptions from participating in federal insurance programs, including Medicare and Medicaid. Next Generation MyCare doesn't change those exemption rights. If you're part of an exempt community and have questions, OSHIIP and the Ohio Department of Medicaid can confirm your status and document the exemption properly.Who's eligible
To enroll in a Next Generation MyCare Ohio plan, you must be:
- 21 years of age or older (the program is for adults).
- Enrolled in both Medicare (Parts A and B) and full Ohio Medicaid — partial-Medicaid dual-eligibles (QMB/SLMB/QI only) are not eligible for MyCare.
- An Ohio resident in a county where the program is active.
- Not enrolled in another Medicare Advantage plan, hospice (most cases), or with End-Stage Renal Disease at the time of enrollment in certain situations (verify with the plan).
If you're under 21, dual-eligible, and would otherwise qualify, traditional Medicaid + Medicare continues to be your structure. Children with complex medical needs may have alternative coordination programs through ODM.
How enrollment works
Three enrollment paths into Next Generation MyCare:
- Auto-enrollment. If you were enrolled in MyCare Ohio under the previous demonstration with one of the four chosen MCOs, you were transitioned to the same MCO's Next Generation MyCare plan on January 1, 2026, unless you opted out or chose differently. You should have received notice from ODM and your MCO in late 2025.
- Active enrollment for newly eligible dual-eligibles or those in newly transitioning counties. You'll receive notification with plan options and an enrollment form, or you can call ODM at 1-800-324-8680 to choose your plan.
- Voluntary enrollment at any time during the year — dual-eligibles have a continuous Special Enrollment Period that lets them join or change plans monthly, unlike standard Medicare beneficiaries who are restricted to AEP.
You can also opt out at any time and return to Original Medicare + traditional Medicaid coordination. There's no penalty for opting out, and you can re-enroll in MyCare later.
Benefits beyond Medicare and Medicaid
Because FIDE-SNPs are required to integrate full Medicare and Medicaid benefits, members receive coverage that's significantly broader than either program alone. Across the four plans, expect:
- All Medicare Part A and Part B services (hospital, doctor visits, outpatient) plus Part D prescription drugs built in.
- Full Ohio Medicaid benefits including long-term services and supports, behavioral health, transportation to medical appointments, and waiver services (PASSPORT, MyCare equivalent).
- Care coordination through a dedicated care manager who knows your medical, behavioral, and social needs.
- Dental, vision, and hearing beyond what either Medicare or Medicaid alone provides.
- Over-the-counter (OTC) allowances — monthly credits for items like vitamins, pain relievers, first aid supplies, and in some plans groceries and utility bill assistance.
- Unlimited non-emergency medical transportation in many plans, helpful for getting to dialysis, physical therapy, and specialist appointments.
- $0 cost for in-network services. As a full dual-eligible, you should not face copays for covered Medicare-Medicaid services.
What current MyCare members should do
If you were a MyCare Ohio member before January 1, 2026, you were transitioned to Next Generation MyCare on that date. Three things to do in your first months on the new plan:
- Read the letter from your MCO describing your new plan benefits, member ID, and care manager assignment. Save the letter — it has the phone numbers and online account information you'll need.
- Confirm your doctors are still in-network. Most providers transitioned, but a few may not have. Call the MCO's member services to verify your primary care provider, specialists, and pharmacies.
- Review the supplemental benefits. OTC allowance, transportation, dental — each plan has slightly different features. Knowing what you have lets you actually use the benefits.
If your plan no longer fits, you can switch to a different Next Generation MyCare plan, or return to Original Medicare + traditional Medicaid, at any time. Dual-eligibles aren't restricted to AEP.