Who is in MyCare Ohio?
Under OAC 5160-58-02, you are enrolled in a MyCare Ohio plan if you are 21 or older and have Medicare Part A, Part B and Part D plus full Ohio Medicaid. You are not enrolled if you are in PACE, on a developmental disabilities waiver or in an ICF-IID, have other creditable health coverage, or are an inmate of a public institution. People with only a Medicare Savings Program (QMB, SLMB or QI) aren't eligible, because MyCare requires full Medicaid.
Two ways to be a member
| Medicaid only | Medicare and Medicaid | |
|---|---|---|
| Medicaid benefits | From your MyCare plan | From your MyCare plan |
| Medicare benefits | Original Medicare or another Medicare plan | From the same MyCare plan |
| ID cards | Up to three | One |
| Care coordinators | Separate teams | One |
The Medicare side of a MyCare plan is a fully integrated dual eligible special needs plan (FIDE SNP). The Ohio Department of Medicaid doesn't auto-assign anyone to a MyCare plan for Medicare; that's your choice, made through Medicare.
What MyCare plans cover
- Medicaid benefits, including behavioral health care and long-term services such as nursing home care and the MyCare Ohio Waiver for home care.
- Care coordination through a care coordinator; MyCare plans work with Ohio's area agencies on aging.
- If you choose the plan for Medicare too, your Medicare hospital, doctor and Part D drug coverage.
The plans and their networks are listed by the Ohio Medicaid Consumer Hotline at ohiomh.com or 1-800-324-8680. This site doesn't name plans. To talk through your Medicare choice, including staying in Original Medicare, you can request a call from a licensed insurance agent. Full details: MyCare Ohio guide.
Related questions
What is Next Generation MyCare Ohio?
What changed in 2026.
Is MyCare Ohio available in my county?
All 88 counties and their start dates.
What is a D-SNP in Ohio?
The Medicare side of MyCare.
Sources
- Ohio Administrative Code — Rule 5160-58-02, MyCare Ohio plans: eligibility, ineligibility, and optional enrollment
- Ohio Department of Medicaid — Next Generation MyCare Member Frequently Asked Questions (April 2026)
- Ohio Medicaid Consumer Hotline — ohiomh.com
More questions in this guide
- Can I have Ohio Medicaid and Medicare at the same time?
- Does Ohio Medicaid pay for nursing home care?
- Does Ohio Medicaid take your house after you die?
- Is MyCare Ohio available in my county?
- What is the difference between Medicare and Medicaid in Ohio?
- What is a dual eligible special needs plan in Ohio?
- What is a qualified income trust (Miller trust) in Ohio?
- What is Next Generation MyCare Ohio?
- What is the PASSPORT waiver in Ohio?
Part of the guide: Ohio Medicaid and Medicare together · All questions
Frequently asked questions
Is MyCare Ohio Medicare or Medicaid?
Both, if you choose. Every eligible person gets Medicaid through a MyCare plan. You can also get Medicare from that plan's dual eligible special needs plan, making it one plan for both, or keep Original Medicare or another Medicare plan.
Do I have to join MyCare Ohio?
For Medicaid, yes, if you meet the rules and aren't excluded. If you don't choose a MyCare plan, the Ohio Department of Medicaid assigns one. Members of federally recognized tribes may opt out.
How do I find out which MyCare plan I have?
Check your MyCare member ID card or the letter from the Ohio Department of Medicaid, or call the Ohio Medicaid Consumer Hotline at 1-800-324-8680.
Does MyCare Ohio cover long-term care?
Yes. MyCare plans cover Medicaid long-term services, including nursing home care and home care through the MyCare Ohio Waiver.
Medicare in your Ohio county
Plans, local agents and help, county by county: Franklin · Cuyahoga · Hamilton · Summit · Montgomery · Lucas · Butler · Stark · Lorain · Warren · Delaware · Lake · Mahoning · Clermont · Trumbull · Licking · Medina · Greene · Fairfield · Portage · All 88 counties →
