Next Generation of Ohio Medicaid Managed Care

Ohio Medicaid’s Next Generation managed care plans provide a personalized approach to support your healthcare needs.

The Next Generation managed care plans changes do not apply to MyCare Ohio plans, which continue to provide benefits to Ohioans who receive both Medicaid and Medicare benefits. Additionally, OhioRISE enrollees continue to receive their behavioral health benefits through Aetna (the OhioRISE plan) and their physical health services through their managed care organization or fee-for-service Medicaid.

The list of resources below is available to help you identify the Next Generation plan that best meets your healthcare needs:

Selecting or Changing a Next Generation managed care plan

You can review and select among the seven Next Generation plan that best fits your healthcare needs and preferences. Ohio Medicaid managed care members are encouraged to review and select the Next Generation plan that best fits their healthcare needs.

Any changes will be made effective on the first day of the month following your selection. To make a Next Generation plan selection or change, Ohio Medicaid members 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.

Members previously enrolled with Paramount Advantage

Paramount Advantage Medicaid has been acquired by Anthem Blue Cross and Blue Shield (Anthem). If you were previously enrolled with Paramount Advantage and did not select a new Next Generation managed care plan, you were automatically enrolled with Anthem Blue Cross and Blue Shield. Members can change their plan at any point within the first 90 days.

Members newly eligible for Medicaid managed care

The individuals listed below previously received care through Medicaid fee-for-service. On February 1, 2023, they may have transitioned to an Ohio Medicaid Next Generation managed care plan. This includes individuals who are:

ODM and the plan each member has been transitioned to have notified impacted members. Newborns and case additions will continue to be added to managed care plans as they become eligible for Medicaid during this time. Members can change their plan at any point within the first 90 days following enrollment.

Members enrolled in the OhioRISE program

OhioRISE enrollees will receive their behavioral health benefits through Aetna (the OhioRISE plan) and their medical, dental, vision and other health services through one of the seven Next Generation managed care programs or fee-for-service Medicaid.

Learn about Just Cause

If members have concerns about access to healthcare, they can request to change or disenroll from their plan at any time for Just Cause. Members can make a Just Cause request by contacting Ohio Department of Medicaid through the Consumer Hotline at 800-324-8680 or reaching out to their managed care plan.

A Just Cause for enrollment is a request to change or disenroll from plans outside of the annual open enrollment period or after the initial 90-day enrollment period. These requests are initiated by calling the Medicaid Hotline at 800-324-8680 Monday through Friday 7am-8pm and Saturday 8am-5pm ET.

Learn more about the Next Generation of Ohio Medicaid

To learn more about the other components of the Next Generation of Ohio Medicaid, please visit the websites below: