How to apply for Next Generation MyCare Ohio — one plan for people with both Medicare and Medicaid

Who it's for

Next Generation MyCare puts Medicare and Medicaid benefits into one health plan for Ohioans who have both. The plan covers all regular Medicare and Medicaid benefits, including long-term care at home, in assisted living or in a nursing home, plus behavioral health. Members get a care team, better rides to appointments and shorter waits for prior approvals, and plans may add extras. The program is now available in every Ohio county. People who qualify are enrolled automatically if they do not pick a plan. People on the PASSPORT, Assisted Living or Ohio Home Care waiver who join move to the MyCare Ohio Waiver with the same or more benefits. To choose or change a plan, call the Ohio Medicaid Consumer Hotline at 800-324-8680.

What you'll need

• Ohio Medicaid card (full Medicaid coverage)
• Medicare card showing Parts A and B, plus Part D drug coverage

Where to apply

What to say when you call

"Hello, I'm calling to ask about Next Generation MyCare Ohio — one plan for people with both Medicare and Medicaid. I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need ohio Medicaid card (full Medicaid coverage), medicare card showing Parts A and B, plus Part D drug coverage — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Make sure you already have full Ohio Medicaid and Medicare Parts A, B, and D. If you do not have Medicaid yet, apply for Medicaid first.
2. Check that this program fits your situation. People in PACE, a Developmental Disabilities waiver or an Intermediate Care Facility, or who have other insurance that covers hospital stays and doctor visits, are not enrolled.
3. Gather your Ohio Medicaid card and your Medicare card showing Parts A and B, plus Part D drug coverage.
4. Apply online or apply by phone at 1-800-324-8680.
5. Choose a Next Generation MyCare plan when you apply, or call the Ohio Medicaid Consumer Hotline at 1-800-324-8680 to choose or change a plan.
6. Complete any steps the state or plan asks for and keep your cards handy in case they need to check your coverage.

What to expect: After you apply, the state will review your coverage and enroll you in a Next Generation MyCare plan if you qualify. If you do not pick a plan, you will be enrolled automatically. Once enrolled, your Medicare and Medicaid benefits will be in one plan. Renewal follows your annual Medicaid renewal, so watch for notices and complete your Medicaid renewal on time.

Renewals

follows your annual Medicaid renewal