MedicaidAdministrativeMedium impact
5160-58-02 - MyCare Ohio plans: eligibility, ineligibility, and optional enrollment. (New/Final File)
Ohio Medicaid·OH·Enrollment
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Ohio's MyCare plans (Medicaid managed care for dual-eligible beneficiaries) have updated their eligibility and enrollment rules, replacing the previous policy with new guidance on who qualifies and how enrollment works. The new rule takes effect January 1, 2026, rescinding the old eligibility-only policy.
Action Required
Before January 1, 2026: Billing team should review patient eligibility verification procedures for MyCare Ohio members (dual Medicare-Medicaid beneficiaries in Ohio). Update staff training on new eligibility criteria and enrollment processes. Contact Ohio Medicaid at 614-752-3877 if clarification is needed on specific patient cases.