Medicaid Managed Care Plans
Managed Care Plans are just like regular private health insurance. After selecting a plan, you will receive an insurance card in the mail, along with information on your doctors and scope of coverage.
Ohio offers a variety of Managed Care Plans, so you can pick the plan that best suits your needs.
Changing your planWhen you are enrolled in Medicaid, you have 90 days to choose a plan. After that, you can only change your plan during November open enrollment.
You may be able to change your plan outside of open enrollment if you can show just cause for the change.
If eligible, you can change your plan online using the Medicaid Consumer Hotline.
The Managed Care Plan system is for the Community Medicaid program, also known as Modified Adjusted Gross Income (MAGI). See other types of Medicaid programs.
Ohio Next Generation Managed Care Plan Update
On Feb. 1, 2023, the Ohio Department of Medicaid will launch the Next Generation managed care plans and program requirements, including exciting improvements that will support members in accessing the healthcare services and supports they need.
What does this mean for members?
There will be no disruption in services for members. The timeline during which a member’s Next Generation managed care plan will be effective varies based on which plan you selected:
- Managed care members that have not made an active plan selection will continue receiving healthcare coverage through their current managed care plan.
- Paramount Advantage members will continue receiving healthcare coverage through Paramount Advantage until Feb. 1. At that time Anthem will be their Next Generation managed care plan unless they selected a different plan prior to Nov. 30, 2022.
- Managed care members that selected a new Next Generation managed care plan including Humana Health Plan of Ohio Inc. or Amerihealth, Caritas Ohio, Inc. will begin receiving services from that plan Feb. 1.
- Managed care members that selected a different continuing plan, such as CareSource Ohio, Inc., Buckeye Health Plan, Molina Healthcare of Ohio, Inc., or United Healthcare Community Plan of Ohio, Inc., will begin receiving services from their new plan on Dec. 1.
- Individuals who are newly eligible for managed care, those who are currently in Medicaid fee-for-service but not enrolled with a managed care plan, and those with a gap in eligibility of 91 or more days will receive care paid for through Medicaid fee-for-service until Feb. 1, when they are transitioned to an Ohio Medicaid Next Generation plan.
If you have questions about your Managed Care Plan please reach out to the Ohio Medicaid Consumer Hotline at 1-800-324-8680 or visit https://members.ohiomh.com.