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MedicaidAdministrativeMedium impact

5160-58-01 - MyCare Ohio plans: definitions. (New/Final File)

Ohio Medicaid·OH·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Ohio Department of Medicaid is updating definitions for MyCare Ohio plans (Ohio's dual eligible special needs plans for Medicare-Medicaid beneficiaries). A new version of the definitions rule will take effect January 1, 2026, replacing the current version.

Action Required

Action needed
By January 1, 2026: Billing teams serving MyCare Ohio members should review updated plan definitions and verify current eligibility verification processes remain compliant with new definitions. Contact MyCare Ohio plans directly for specific billing guideline changes that may result from these definition updates.