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2022 Next Generation Plan Enrollment/Medicaid Managed Care FAQ Webpage

On December 1, 2022, Ohio Medicaid’s Next Generation managed care plans will provide a more personalized approach to support your healthcare needs. Ohio Medicaid members are encouraged to select their Next Generation managed care plan now!

The Next Generation managed care plans changes do not apply to MyCare Ohio plans, which will continue to provide benefits to Ohioans who receive both Medicaid and Medicare benefits, with enhanced coordination of medical, behavioral, and long-term care services.

Ohio Medicaid managed care members can review and compare the seven Next Generation managed care plans available and choose the Next Generation plan that best fits their healthcare needs.

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

• The Next Generation Health Plan Comparison document provides an overview of the services that all Next Generation managed care plans provide as well as, specific value-added services provided by each individual plan.
• The Member Transition Enrollment Infographic shows member actions, important dates, and resources available.
• The Find A Provider search tool can help you identify which Next Generation managed care plans your trusted providers are contracted - or "in network" - with.
• Each Next Generation managed care plan has a member website that you can visit to learn more about their approach to serving Ohio Medicaid managed care members:
  • AmeriHealth Caritas Ohio, Inc.
  • Anthem Blue Cross and Blue Shield
  • Buckeye Health Plan
  • CareSource Ohio, Inc.
  • Humana Healthy Horizons in Ohio
  • Molina HealthCare of Ohio, Inc.
  • UnitedHealthcare Community Plan of Ohio, Inc.
• Call the Medicaid Consumer Hotline at (800) 324-8680 if you have additional questions about the Next Generation managed care plan options available.
• The Ohio Medicaid Managed Care Member FAQ answers questions related to member transition and background about Ohio Medicaid's Next Generation program.

Selecting a Next Generation managed care plan

To make a Next Generation plan selection, 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.

Timeline for choosing a Next Generation managed care plan

Ohio Medicaid managed care members are encouraged to review and select the Next Generation plan that best fits their healthcare needs now.

You will remain with your current managed care plan until Ohio Medicaid's Next Generation managed care plans begin providing healthcare benefits on December 1, 2022. You can review and select the Next Generation plan that best fits your healthcare needs at any time through open enrollment ending November 30, 2022.

Current members with Buckeye, CareSource, Molina, or UnitedHealthcare

Current Ohio Medicaid managed care members who do not select a plan - to either move to a new plan or stay with their current plan - will remain with their current plan.

Current members with Paramount

Paramount Advantage Medicaid has been acquired by Anthem Blue Cross and Blue Shield (Anthem). Anthem is working with Paramount Advantage to continue providing your healthcare coverage and you will continue receiving healthcare coverage through Paramount Advantage until the Next Generation managed care plans begin providing healthcare coverage. At that time Anthem will be your Next Generation managed care plan. You do not need to take any action to begin receiving healthcare benefits through Anthem and there will be no disruption in your care. All Ohio Medicaid managed care members can select a different plan at any time until the end of open enrollment through November 30.

Members newly eligible for Medicaid managed care

Individuals who are newly eligible for managed care, those who are currently in Medicaid fee-for-service but not enrolled with a managed care plan, and those with a gap in eligibility of 91+ days will receive care paid for through Medicaid fee-for-service until December 1, 2022 when they are transitioned to an Ohio Medicaid Next Generation plan.

ODM will notify impacted members which plan they have been transitioned to. Members can review and select the Next Generation plan that best fits their healthcare needs at any time through open enrollment through November 30, 2022. Newborns and case additions will continue to be added to managed care plans as they become Medicaid eligible during this time.

Members enrolled in the OhioRISE program

OhioRISE enrollees will receive their behavioral health benefits through Aetna (the OhioRISE plan) and their physical health services through one of the Seven Next Generation managed care programs or fee-for-service Medicaid.

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:

• OhioRISE (Resilience through Integrated Systems and Excellence)
• Single Pharmacy Benefit Manager

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