Next Generation MyCare Ohio: Plans, Eligibility, and Enrollment in 2026
Next Generation MyCare is now available in every Ohio county. Ohio launched the program in the original 29 MyCare counties on January 1, 2026, and completed its statewide expansion on August 1, 2026. [1]
If you or a loved one has both Medicare and Medicaid, Next Generation MyCare may help coordinate healthcare and long-term services and supports. This post explains who may qualify, which plans are available, how enrollment works, and what family caregivers should know about waiver services.
What Is Next Generation MyCare Ohio?
Next Generation MyCare is an Ohio Medicaid managed care program for certain Ohioans who have both Medicare and full Medicaid coverage. People who qualify for both programs are sometimes called “dual eligible.”
The program is designed to make healthcare and long-term services easier to coordinate. Depending on how a member enrolls, Medicare and Medicaid benefits may be managed by the same organization.
Is Next Generation MyCare Available Statewide?
Yes. Next Generation MyCare is now available in all 88 Ohio counties.
The rollout happened in two main stages:
- January 1, 2026: The program began in the 29 counties that previously participated in MyCare Ohio.
- April 1 through August 1, 2026: Ohio expanded the program to the rest of the state in regional phases.
- August 1, 2026: The final expansion phase took effect, completing the statewide rollout.
The phased rollout is now complete. Members no longer need to wait for the program to become available in their county. [1]
Who May Qualify for Next Generation MyCare?
According to current Ohio Medicaid guidance, a person generally must:
- Be 21 years of age or older
- Have full Medicaid coverage
- Be enrolled in Medicare Parts A, B, and D
- Live in Ohio
Some people with Medicare and Medicaid are not enrolled in Next Generation MyCare. This may include people enrolled in PACE, a Developmental Disabilities waiver, an Intermediate Care Facility, or certain other comprehensive health coverage arrangements. [1]
Having Medicare and Medicaid does not automatically mean someone will qualify. Ohio Medicaid determines eligibility based on each person’s circumstances. You can also call the Ohio Medicaid Consumer Hotline at 800-324-8680 for an official eligibility determination.
How Do Medicare and Medicaid Work Together Under MyCare?
Not every member will have Medicare and Medicaid coverage through the same plan.
Members who align both benefits through the same Next Generation MyCare organization will have one plan, one member ID card, and one care coordinator. This can make it easier to coordinate services and know whom to contact with questions.
A member can also enroll in Next Generation MyCare for Medicaid benefits while keeping Medicare coverage through a different organization. In that situation, the member can have separate plans, ID cards, provider networks, and care teams. [1]
If you are unsure how a member’s coverage is arranged, contact the member’s plan, call Medicare at 800-633-4227, or call the Ohio Medicaid Consumer Hotline.
Which Next Generation MyCare Plans Are Available?
Ohio Medicaid identifies four organizations participating in Next Generation MyCare:
- Anthem Blue Cross and Blue Shield
- Buckeye Health Plan
- CareSource
- Molina Healthcare of Ohio
However, only three are generally available to new members statewide in 2026:
- Anthem Blue Cross and Blue Shield
- CareSource
- Molina Healthcare of Ohio
Buckeye remains part of the program for certain existing members but is not available as a new-member plan choice during plan year 2026. Additional Buckeye restrictions apply in Belmont and Ashtabula counties. [1]
Plan participation and availability may change. Confirm the current choices with the Ohio Medicaid Consumer Hotline before enrolling or changing plans.
How Does Enrollment Work?
Ohio Medicaid sends eligible members information about their plan, coverage start date, and available choices.
If an eligible person did not select a plan before Next Generation MyCare became available in their county, Ohio Medicaid may have automatically enrolled them in a plan for Medicaid benefits. Automatic Medicaid enrollment does not always mean the member’s Medicare coverage was moved into the same plan. [1]
A member enrolled in a Next Generation MyCare plan for Medicaid benefits may generally change plans within the first 90 days after enrollment. A later change may require an approved “just cause” reason. [1]
Members whose Medicare and Medicaid benefits are aligned may have different options for changing coverage through Medicare. Before changing plans, confirm that important doctors, prescriptions, pharmacies, and waiver providers are covered.
For help comparing or changing plans, call the Ohio Medicaid Consumer Hotline at 800-324-8680.
Will Existing Services and Providers Continue?
Ohio Medicaid and the participating plans provide transition-of-care protections for certain services, providers, prescriptions, and waiver arrangements. [1]
However, this does not mean every provider can continue indefinitely under every plan. After an applicable transition period, a member may need to use providers in the plan’s network. If an approved service, prescription, or provider is unexpectedly interrupted, contact the member’s plan promptly. If you need help understanding your caregiving options or deciding where to start, reach out to CareOasis.
Frequently Asked Questions
Is Next Generation MyCare Available in Every Ohio County?
Yes. Ohio completed the statewide rollout on August 1, 2026. Next Generation MyCare is now available in all 88 counties.
Which Plans Can New Members Choose in 2026?
New members can generally choose Anthem Blue Cross and Blue Shield, CareSource, or Molina Healthcare of Ohio. Buckeye Health Plan remains relevant for certain existing members but is not accepting new Next Generation MyCare members in plan year 2026.
Can I Change My Next Generation MyCare Plan?
Medicaid-only members may generally change plans during the first 90 days after enrollment. A later change may require an approved just-cause reason. Different rules may apply when Medicare and Medicaid are aligned, so contact the Ohio Medicaid Consumer Hotline or Medicare before making a change.
How Does Next Generation MyCare Affect PASSPORT Waiver Services?
Qualifying PASSPORT members who enrolled in Next Generation MyCare generally transitioned to the MyCare Ohio Waiver, where Ohio Medicaid says they have access to the same benefits or more. People who are not enrolled in Next Generation MyCare generally remain in their original waiver program. [1]
Learn more about how the PASSPORT Waiver works in Ohio and other Ohio Medicaid waiver pathways.
Can a Family Member Be Paid to Provide Care?
Yes, some family caregivers may qualify to be paid through an authorized waiver or self-directed service arrangement. Conditions apply based on the member’s assessed needs and approved service plan, the caregiver’s relationship to the member, and provider requirements. [2]
If you think your family may qualify, contact CareOasis to start the process. We can help you understand which caregiving options may fit your situation and what steps to take next. You can also review our guide to applying for caregiving benefits through PASSPORT or MyCare and learn when a spouse may be paid as a caregiver under an Ohio Medicaid waiver.
Where to Get More Information
Official Resources
| Resource | How It Can Help |
|---|---|
| Ohio Medicaid: Next Generation MyCare | Current program announcements and resources |
| Next Generation MyCare Member FAQ | Detailed guidance for current and prospective members |
| Ohio Medicaid Consumer Hotline: 800-324-8680 | Eligibility, enrollment, current plan information, and plan changes |
| Medicare: 800-633-4227 | Medicare enrollment and aligning Medicare with a Next Generation MyCare plan |
| Ohio Senior Health Insurance Information Program: 800-686-1578 | Free help comparing Medicare coverage options |
Plan Phone Numbers
| Plan | Phone Number |
|---|---|
| Anthem Blue Cross and Blue Shield | 833-727-2169 |
| CareSource | 855-475-3163 |
| Molina Healthcare of Ohio | 866-856-8295 |
| Buckeye Health Plan* | 855-445-3562 |
*Buckeye Health Plan is not available to new Next Generation MyCare members during plan year 2026.
Program rules and plan availability may change. Confirm current information with Ohio Medicaid, Medicare, or the member’s managed care plan before changing coverage.
Sources
Get support for your caregiving journey today
We help you get certified as a caregiver and enroll in federal programs to receive compensation for family caregiving. Start your CareOasis journey now.