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MyCare Ohio vs. Original Medicare and Medicaid

If you have full Ohio Medicaid and Medicare, you're enrolled in a MyCare Ohio plan for Medicaid and choose how to get Medicare: from the same MyCare plan (one plan for both) or from Original Medicare or another Medicare plan. If you have only a Medicare Savings Program, MyCare doesn't apply, and a coordination-only D-SNP is one option.

By the Benefits Life Editorial Team, licensed insurance agents · Reviewed November 13, 2026

The three setups

MyCare plan for both: full Medicaid, and you choose your MyCare plan's Medicare side, a fully integrated D-SNP (FIDE SNP).
Original Medicare + MyCare for Medicaid only: full Medicaid through MyCare; Medicare through Original Medicare and a standalone Part D plan (or another Medicare plan).
D-SNP for Medicare Savings Program members: no full Medicaid, so no MyCare; a coordination-only D-SNP covers Medicare while the Medicare Savings Program pays premiums.

Side by side

Question	MyCare plan for Medicare and Medicaid	Original Medicare + MyCare for Medicaid only	Coordination-only D-SNP (MSP only)
Who can use it	Age 21+, Medicare A, B and D, full Medicaid	Same people as MyCare	People with QMB, SLMB, QI or QDWI and not full Medicaid
Medicare comes from	Your MyCare plan's FIDE SNP	Original Medicare (Parts A and B) plus a Part D plan	The D-SNP
Medicaid comes from	The same MyCare plan	Your MyCare plan	Your Medicare Savings Program through Ohio Medicaid
Doctors and hospitals	The plan's network, after a transition period	Any provider that accepts Medicare for Medicare services; MyCare network for Medicaid services	The plan's network
Drug coverage	Included in the plan	A separate Part D plan you pick	Included in the plan
ID cards	One	Up to three, per ODM	The D-SNP card plus your Medicaid card
Care coordination	One care coordinator	Separate Medicare and Medicaid teams	The D-SNP coordinates with Ohio Medicaid
Long-term services and waiver	MyCare Ohio Waiver and nursing home care through the plan	MyCare Ohio Waiver and nursing home care through the MyCare plan	Not covered by an MSP; would need full Medicaid
Appeals	One organization	Medicare, Part D plan and MyCare plan separately	D-SNP for Medicare; Ohio Medicaid for MSP
Medicare cost sharing	Covered as Medicaid allows	Medicaid pays after Medicare as it allows	QMB: providers can't bill you; SLMB/QI: premium help only
Changing	Any month through Medicare	Medicaid plan within 90 days, then for just cause; Part D monthly	Monthly Part D period and other federal periods

Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.

How to choose

List your doctors, hospitals and drugs. Check them against each MyCare plan's network (ohiomh.com provider search) and each Part D plan's formulary.
Think about how much coordination you need. People using waiver services, behavioral health care or frequent hospital care often value having one care coordinator.
Check your MyCare letter. It names your plan, its start date and your options. Read it carefully if it says you'll get Medicare from your plan.
Make the change. MyCare plan choices: Ohio Medicaid Consumer Hotline, 1-800-324-8680. Medicare choices: 1-800-MEDICARE (1-800-633-4227). Changes generally start the first of the next month.

To talk through Medicare plans from the companies they work with, you can request a call from a licensed insurance agent. For details see MyCare Ohio, D-SNPs in Ohio and Medicare Savings Programs in Ohio.

Sources

Frequently asked questions

Is it better to get Medicare from my MyCare plan?

It depends on your doctors, drugs and care needs. One plan means one card, one care coordinator and one place for appeals. Keeping Original Medicare lets you see any provider that accepts Medicare, but you deal with separate Medicare, Part D and Medicaid organizations. Check whether your doctors and drugs are covered before you choose.

Can I keep Original Medicare if I'm in MyCare Ohio?

Yes. MyCare is mandatory only for Medicaid. You can keep Original Medicare with a standalone Part D plan, and your MyCare plan covers only your Medicaid benefits.

Does Ohio Medicaid fee-for-service still exist for people with Medicare?

For people with full Medicaid and Medicare Parts A, B and D who are 21 or older, Medicaid comes through MyCare in all 88 counties since August 1, 2026. Medicaid outside MyCare applies to people MyCare excludes, such as PACE members, people on a developmental disabilities waiver, and people who lack Part A, B or D.

What if I have only QMB or SLMB?

You aren't eligible for MyCare, which requires full Medicaid. Your Medicare Savings Program pays Medicare premiums (and, with QMB, cost sharing). For Medicare coverage you can choose Original Medicare with Part D, a regular Medicare Advantage plan, or a coordination-only D-SNP.

Medicare in your Ohio county

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Licensed insurance agents for Ohio

These independent insurance agents are licensed in Ohio and work with Benefits Life, the publisher of this site. When they enroll you in a plan, the agent and Benefits Life may be paid by the insurance company. Learn more.