Depending on where you live in Ohio, you must choose a Managed Care Plan if you are eligible for Medicaid. If you do not enroll in a Managed Care Plan one will be chosen for you.
What is Managed Care?
Managed Care Plans (MCPs) are health care companies. MCPs work with certain doctors and hospitals. These doctors agree to give you care and help you get the medical attention you need from other health care providers.
Who must join an MCP?
Most adults and children who receive Healthy Start, Healthy Families Medicaid must join an MCP when they receive the notice by mail. Certain consumers may not be required to join an MCP. They are children under the age of 19 in certain circumstances.
What to do When You Receive Notice About Choosing an MCP
If you get a notice, read it carefully. It will tell you what to do. Once you get the notice, you can call the Selection Services Center (SSC) at 800-605-3040 to choose a plan and to get your questions answered. They are open Monday through Friday, 8:00 am to 8:00 pm to answer your questions and help you make a choice about which MCP to join.
What If You Have Medicare and Medicaid?
Consumers who get both Medicare and Medicaid cannot join a Medicaid MCP. Tell the SSC when you call that you get both Medicare and Medicaid.
In a Managed Care Plan:
- The doctor you choose must be a doctor who is on your MCP`s provider list.
- You will get the same medically necessary services that the Medicaid Card offers. Many MCPs offer additional services that are not covered by Medicaid.
- You will not get your medical card in the mail every month. Instead, you will get an MCP Member ID Card. Keep this card until your MCP sends you a new one.
Your MCP will provide you with all the same services available with the Medicaid card.
How Do You Select An MCP?
- Call the Selection Services Center for Medicaid Managed Care at 800-605-3040.
- Meet face-to-face with an Outreach & Education Counselor at the County Department of Job & Family Services.
- Call to request an information packet by mail.
Can You Change Your MCP?
- You may change your MCP for any reason within the first three months of your initial selection.
- You may change your MCP every year during your open selection month.
- You may change your MCP if you have a “just cause” or for continuity of care.
- As a member of a Medicaid managed care plan, you have the option to change the plan that you have selected within the first three months of your membership or annually, thereafter, during your region`s open enrollment month, which is January for counties: Adams, Brown, Butler, Clermont, Clinton, Hamilton, Highland and Warren.