Ohio Launched Statewide Next Generation MyCare Program
The state program for dually eligible residents expanded statewide on August 1, 2026, to coordinate care.
Updated on Oct. 3, 2026 in Eldercare
Live Poll
Do you feel confident navigating changes to your state-managed healthcare coverage?
Ohio officially implemented the Next Generation MyCare program statewide on August 1, 2026. This initiative auto-assigns residents eligible for both Medicare and Medicaid to managed care plans to streamline benefit coordination.
Why it matters
The program aims to simplify healthcare management for dually eligible individuals by processing both Medicare and Medicaid claims through a single plan. This centralized approach is intended to provide more efficient care coordination for participants.
The state has contracted with four managed care plans: Anthem, Buckeye, CareSource, and Molina. Participants are granted a 60-day window to change their state-assigned Medicaid plan.
The players
Ohio Department of Medicaid
This is the state agency responsible for managing the health coverage programs for low-income residents and dually eligible individuals.
Anthem
This is a health insurance company that has been awarded a contract to serve as one of the state's managed care plan providers.
Buckeye
This is a managed care organization contracted by the state to administer Medicaid benefits under the new program.
CareSource
This is a non-profit health insurance plan that provides services for Ohioans enrolled in state-sponsored healthcare programs.
Molina
This is a national healthcare company that operates as one of the four managed care plans under the state's updated framework.
The details
The Ohio Department of Medicaid utilizes existing provider contract data to determine plan assignments and notifies residents via letter. While the state handles Medicaid transitions, individuals must still manually enroll in their desired Medicare plan.
Timeline
Aug. 1, 2026: The Next Generation MyCare program became statewide.
August 2026: The second round of auto-assignment notification letters was issued.
Sept. 1, 2026: The first round of auto-assigned participants transitioned to their plans.
Oct. 1, 2026: The second round of auto-assigned participants transitioned to their plans.
Oct. 15 to Dec. 7, 2026: The Annual Medicare Open Enrollment Period occurs.
Culture Shift
The transition to the Next Generation MyCare program follows a broader shift toward integrated managed care for dually eligible populations. This model attempts to move away from fragmented billing toward a unified administrative framework for complex health needs.
Dually eligible residents should monitor their mail for assignment letters and contact the Ohio Medicaid Consumer Hotline at 800-324-8680 if they wish to change their plan within the 60-day window. Participants must remember that Medicare enrollment remains a manual process distinct from Medicaid plan assignments.
The takeaway
Managed care transitions require proactive engagement from participants to ensure their preferred providers remain in-network. Residents should leverage the open enrollment window to verify that their coverage choices align with their specific medical needs.
Further reading
For additional context on programs supporting older adults, visit the Eldercare section.
More information
For more information, visit the Ohio Medicaid consumer information portal.
Source note: This article includes information reported by Jenkins Care Community.
Live Poll
Do you feel confident navigating changes to your state-managed healthcare coverage?
