09/18/2025

Next Generation MyCare Program Begins in 2026

The Ohio Department of Medicaid will launch its Next Generation MyCare program on January 1, 2026, beginning in the 29 counties where MyCare Ohio is already available and expanding statewide later in the year. The program is designed to simplify care for Ohioans with both Medicaid and Medicare by aligning benefits in a single plan, improving coordination, and reducing administrative hurdles for providers.

For providers, the transition will bring new requirements. All must be enrolled with Medicaid through the provider portal and maintain contracts with individual plans. Claims will be submitted through the Ohio Medicaid Enterprise System using the member’s Medicaid identification number. Two current plans, Aetna Better Health of Ohio and United Healthcare Community Plan, will exit the program at the end of 2025, though they will continue paying claims for services delivered through December 31 of that year.

ODM has prepared several resources to help providers and members understand the changes. The program overview one-pager explains who the program serves and how it works. Providers can find key contact information in the help desk one-pager and answers to common questions in the provider FAQ. Members will also receive updated identification cards, with details available in the ID card information sheet.

LeadingAge Ohio will continue to monitor the rollout and share timely updates to support providers and the individuals they serve through this important transition.