Coordinated care for Ohioans who receive Medicare and Medicaid benefits.
MyCare Ohio is a managed care system for Ohioans who receive BOTH Medicare and Medicaid benefits. The program is administered by the Ohio Department of Medicaid (ODM). Council on Aging works as part of a team of professionals to deliver services to some MyCare Ohio members.
MyCare Ohio is mandatory for most people who receive services through Medicare and Medicaid. This may include people who are already enrolled or thinking about enrolling in a waiver program such as PASSPORT, the Assisted Living Waiver, or Ohio Home Care Waiver.
In southwestern Ohio, enrollment in MyCare Ohio is mandatory for people who:
If you are eligible for MyCare Ohio, you will receive a letter from the Ohio Department of Medicaid explaining how to enrol in the program and choose a health plan.
MyCare Ohio offers a more coordinated way to get the care you need.
Your MyCare Ohio plan includes all standard benefits available through traditional Medicare and Medicaid programs, including:
The Ohio Department of Medicaid has awarded contracts to two health palns to serve MyCare Ohio members who live in Butler, Clermont, Clinton, Hamilton and Warren counties:
When you choose a plan and enroll in MyCare Ohio, you become a member of that plan and receive a member card. Your plan is your point of contact for all your services and questions related to your care. You can change plans on a monthly basis.
Things to think about when choosing a plan:
Aetna and Molina have contracted with Council on Aging for two functions:
As a contractor for the health plans, our role is somewhat different than it has been in the past. We are still the same Council on Aging, providing the knowledgeable and compassionate care we always have. But now, we are a provider for MyCare Ohio and the management functions belong to the two health plans. This means we can make recommendations about a member's care, but we cannot approve or authorize services. That is done by the health plans.
Here's an example: If a MyCare Ohio member needs new services, additional hours or service changes, Council on Aging care managers make recommendations to the health plans, but the health plans decide whether to act on those recommendations. It works like other insurance you’re familiar with for medical care. Your doctor can recommend a certain treatment, but the insurance company decides whether that treatment will be covered.
NOTE: If you are currently enrolled in a MyCare Ohio health plan and are applying to a waiver program for the first time (PASSPORT, Assisted Living Waiver, or Ohio Home Care), you must contact your health plan to apply. Council on Aging cannot enroll MyCare Ohio members in a waiver program without their health plan's approval.
The hotline is available Monday – Friday, 7am - 8pm and Saturdays, 8am - 5pm.
From the hotline's website, you can:
The hotline website is available 24/7.
Once you are enrolled in a MyCare Ohio plan, your assigned care manager will be your primary contact for your all health care, behavioral health and long-term care needs.
Plan Benefits and Provider Network
For questions about your Aetna coverage:
Aetna Better Health of Ohio
For qestions about your Molina coverage:
MyCare Ohio Ombudsman
Ombudsmen field complaints about long-term care services, voice clients' needs and concerns to nursing homes, home health agencies, and other providers of long-term care. They work with you, your family or other representatives, and your care providers to resolve problems and concerns you may have about the quality of services you receive.
To reach the MyCare Ohio Ombudsman for Butler, Clermont, Clinton, Hamilton and Warren counties:
To speak with a local Ombudsman about issues NOT related to MyCare Ohio:
Pro Seniors Inc.
If you live outside our area, you can locate the Long-Term Care Ombudsman Program serving your county in Ohio at the Office of the State LTC Ombudsman website.
Help with MyCare Ohio