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Medicare AdvantageAdministrativeMedium impact

5160-58-02.2 - MyCare Ohio waiver: eligibility and enrollment. (Amend/Final File)

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

Summary

Ohio Department of Medicaid has updated the MyCare Ohio waiver eligibility and enrollment rules effective January 1, 2026. This policy governs dual-eligible special needs plan enrollment for Medicare-Medicaid beneficiaries in Ohio.

Action Required

Action needed
By January 1, 2026: Billing team should verify patient eligibility in MyCare Ohio waiver program for dual-eligible Medicare-Medicaid patients in Ohio. Contact Ohio Department of Medicaid at 614-752-3877 for specific enrollment criteria changes. Update patient insurance verification procedures to confirm MyCare Ohio coverage status.