Ohio Medicaid planning relaunch of MyCare to bring program statewide in January 2026

By Samantha Wildow / June 3, 2024

State seeking providers for Next Generation MyCare program

The Ohio Department of Medicaid is planning to relaunch MyCare, which previously existed for select individuals who were dually eligible for Medicaid and Medicare, as part of an initiative to make the program available to all Ohioans.

As part of the relaunch, expected in January 2026, Ohio Medicaid is inviting managed care plans to apply to become providers of Ohio’s Next Generation MyCare program. The program, which is currently only available in 29 counties, will expand statewide following a competitive selection and preparation process with the plan providers.

“MyCare provides people with peace of mind that their needs are being met and has helped more Ohioans remain in their homes or preferred location to receive care,” said Maureen Corcoran, director of Ohio Medicaid.

Ohio Medicaid launched the current MyCare program in 2014, and it has served nearly 150,000 people in select regions of the state. It is the nation’s second largest dual eligible demonstration initiative.

The MyCare expansion to bring the program statewide was included in the state’s operating budget, Corcoran said.

“We will be able to serve more of the estimated 250,000 Ohioans who are MyCare-eligible, helping them focus on their health care rather than maneuvering through health care coverage,” Corcoran said.

MyCare is designed to eliminate the challenges people face navigating between Medicare and Medicaid.

The Next Generation MyCare plan providers will be expected to develop and sustain an array of care coordination that takes the burden off the member and assures access to the full suite of health benefits available through each program, Ohio Medicaid said.

Ohio’s MyCare program has saved Ohioans nearly $1.7 billion over the last five years, according to a 2023 CMS-required actuarial study.

The expansion is being modeled after Ohio Medicaid’s Next Generation managed care program.

The goal for the Next Generation MyCare program is for members to experience less disruption to care as they can retain their selected plan, regardless of where they live in Ohio, and will keep that plan if they move to a different area of the state.

Ohio’s Next Generation MyCare program will serve individuals ages 21 and older. It will also offer many of the enhancements introduced in Ohio Medicaid’s Next Generation managed care program, including:

• Focusing on the individual.

• Improving individual and population wellness and health outcomes.

• Creating a personalized care experience.

• Supporting providers in continuously improving care.

• Improving care for individuals with complex needs to promote independence in the community.

• Increasing program transparency and accountability.