Ohio Medicaid Managed Care
Ohio Medicaid’s managed care plans provide a personalized approach to support your healthcare needs.
The resources listed below help you understand your options to identify the managed care plan that best meets your healthcare needs:
- The Managed Care Health Plan Comparison Guide provides an overview of the services that all managed care plans offer as well as the specific value-added services available from each individual plan.
- The Managed Care Plan Report Card shows how Ohio Medicaid managed care plans compare to one another in key performance areas.
- The Find a Managed Care Provider search tool can help identify the managed care plans contracting with ("in network,") your trusted providers.
- The Open Enrollment FAQ answers questions related to annual managed care open enrollment.
- Each managed care plan has a member website that you can visit to learn more about their approach to serving Ohio Medicaid managed care members:
- Call the Medicaid Consumer Hotline at 800-324-8680 (TTY 711) if you have questions about the plan options available. Representatives are available Monday through Friday 7 a.m.-8 p.m. and Saturday 8 a.m.-5 p.m. ET. Representatives are available Monday through Friday 7 a.m.-8 p.m. and Saturday 8 a.m.-5 p.m. ET.
- Medicaid Managed Care Member FAQs answers questions related to the managed care program and background about Ohio Medicaid's managed care program.
Selecting or changing a managed care plan
Ohio Medicaid wants you to receive benefits from the managed care plan that best fits your healthcare needs and preferences. If you do not feel you are receiving the care that is best for you, you have options to change your plan.
-
Annual open enrollment
Open enrollment occurs every year during the month of November. All members can change their plan during open enrollment. Your plan selection will be effective the first day of the month following the selection.
-
Just cause
If you have concerns about your plan and access to healthcare, you can request to change or disenroll from your plan at any time for Just Cause – a request to change or disenroll from plans outside of the annual open enrollment period or after the initial 90-day enrollment period due to concerns about not receiving benefits needed. You can make a Just Cause request by contacting Ohio Department of Medicaid through the Ohio Medicaid Consumer Hotline at 800-324-8680 (TTY 711) or reaching out to your managed care plan.
To make a plan selection you can either visit the Ohio Medicaid Consumer Hotline Portal at https://members.ohiomh.com or contact the Ohio Medicaid Consumer Hotline at 800-324-8680 (TTY 711). Representatives are available Monday through Friday 7 a.m.–8 p.m. and Saturday 8 a.m.–5 p.m. Eastern time.
Members enrolled in the OhioRISE program
OhioRISE enrollees will receive your behavioral health benefits through Aetna (the OhioRISE plan) and your medical, dental, vision and other health services through one of the seven managed care programs or fee-for-service Medicaid.