MedicaidAdministrativeHigh impact
5160-58-02 - MyCare Ohio plans: eligibility and enrollment. (Rescind/Final File)
Ohio Medicaid·OH·Enrollment
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
The previous MyCare Ohio eligibility and enrollment rule (5160-58-02) is being rescinded and replaced with a new rule titled 'eligibility, ineligibility, and optional enrollment.' This represents a significant restructuring of Ohio's dual-eligible special needs plan enrollment requirements and processes.
Action Required
By January 1, 2026: Billing team must review and update patient eligibility verification processes for MyCare Ohio members. Contact Ohio Medicaid at 614-752-3877 (Tommi Potter) to obtain the new rule details and determine specific changes to enrollment criteria. Update billing system rules for dual-eligible patients and train staff on new eligibility requirements before the effective date.