Ohio Medicaid Managed Care
Ohio Medicaid’s managed care plans provide a personalized approach to support your healthcare needs.
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 managed care plan that best meets your healthcare needs:
- The Managed Care Health Plan Comparison 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 Find a Provider search tool can help you identify which managed care plans your trusted providers are contracted or "in network" with.
- 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:
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Call the Medicaid Consumer Hotline at (800) 324-8680 if you have additional questions about the managed care plan options available.
- Representatives are available Monday through Friday 7am-8pm and Saturday 8am-5pm ET.
- The Ohio Medicaid Managed Care Member FAQ answers questions related to the managed care program and background about Ohio Medicaid's managed care program.
- The Open Enrollment FAQ answers questions related to annual managed care open enrollment.
Selecting or Changing a managed care plan
Ohio Medicaid wants all members 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:
- Open enrollment occurs every year between November 1 – 30. All members can change their plan during open enrollment. A member's plan selection will be effective the first day of the month following the selection. Additional information will be sent to you before November.
- At any time, if a member has concerns about access to the healthcare services they need, they can request to change or disenroll from their plan for Just Cause. To learn more about Just Cause, please refer to the “Learn about Just Cause” section of this webpage below.
Any changes will be made effective on the first day of the month following your selection. To make a 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.
- Representatives are available Monday through Friday 7am-8pm and Saturday 8am-5pm ET.
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 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 Ohio Medicaid's managed care program
To learn more about the other components of the Ohio Medicaid program, please visit the websites below: