What is MyCare Ohio?
- MyCare Ohio is a program jointly run by the Ohio Department of Medicaid and the federal government (Centers for Medicare Services) to provide better health care for people who have both Medicare and Medicaid. To make getting care easier for individuals who receive both Medicare and Medicaid, MyCare Ohio brings the programs together under a managed care plan to be your single point of contact. CareSource MyCare Ohio will coordinate both your Medicare and Medicaid benefits for you so that you get the most out of your health plan.
Who is CareSource?
- CareSource is a leading not-for-profit health plan that was established in 1989. One of the largest Medicaid providers in the nation, CareSource serves diverse populations with nearly 2 million members. In addition to Medicaid, CareSource focuses on Dual Special Needs plans and the Health Insurance Marketplace in a multi-state area.
How can I become a member of CareSource?
- Visit ohiomh.com and select “I Would Like To Change My Plan”Follow the prompts to check your eligibility. You will answer a few questions about your household size and monthly income. This will help figure out if you may qualify.
- If you may qualify, follow the prompts to apply for benefits. You will complete an online application and submit through the Ohio Department of Medicaid portal.
- You can also contact the Ohio Medicaid Consumer Hotline at 1-800-324-8680 (TTY: 1-800-292-3572) and tell them you want CareSource.
What are the advantages of being a member of CareSource?
CareSource MyCare Ohio helps members that qualify for both Medicare and Medicaid get better health care. . Through person-centered care, you can focus on your life. We can coordinate both your Medicare and Medicaid health care services to help you get the support your need. You can focus on your life while we coordinate Medicare and Medicaid health care services for you. You will receive all the same services as regular Medicaid and Medicare, including prescription drugs. And CareSource offers more. These are just a few of our additional services.
- Transportation We offer free rides to doctor visits and more.
- Behavioral Health Unlimited medically necessary counseling and addiction.
- CareSource24® This is our free, 24-hour Nurse Advice Line.
- Care and Disease Management We can help you coordinate care and manage special conditions such as hypertension, asthma and diabetes.
- MyHealth with personalized health tools to create a wellness plan and track your progress!
- myStrength A secure online tool for behavioral health.
- Silver&Fit® Exercise & Healthy Aging program
For some services you must have CareSource for both Medicare and Medicaid.
What is a prior authorization? What services need prior authorization?
- Some services require prior authorization from CareSource MyCare Ohio before you can get them. This means your doctor or health practitioner must get approval from CareSource MyCare Ohio before you can get the service. View the Prior Authorization List for a list of services needing an okay from us. If you have questions about the prior authorization process or status, please call 1-855-475-3163 (TTY: 1-800-750-0750 or 711).
Renew Your Benefits
Do I need to renew my CareSource benefits each year?
- You must renew your Medicaid benefits once every 12 months. Both CareSource and the State will send you a reminder notice each year. You must reapply if you receive a termination notice.
What if I miss my deadline to renew my benefits?
- You have 90 days to complete your renewal from the end date of your Medicaid. If you miss this deadline your health care benefits will end. You will receive a letter of termination.
Where can I get help with the “redetermination” or renewal process?
- You can visit your local Job and Family Services (JFS) office or call the Ohio Medicaid Consumer Hotline at 1-800-324-8680. Hours for the Medicaid Consumer Hotline are 7:00 a.m. – 8:00 p.m., Monday – Friday and Saturday 8:00 a.m. – 5:00 p.m.
Get a CareSource member ID Card, Plan Documents or Change Your Doctor
How do I get a new CareSource member ID card?
- You can get a new member ID card by logging in to your My CareSource account and clicking “Request ID Card.” You can also download our mobile app and view your ID card on the go. Or call Member Services for a new member ID card.
How do I get a new CareSource member handbook or provider directory?
- All new members receive a welcome letter and postage-paid request cards for both a member handbook and a provider directory. If you want either of these all you have to do is drop the card in the mail to us! We’ll mail you what you requested. You can also view copies online or call Member Services.
How do I select or change my primary care provider (PCP)?
- You are not required to see the PCP listed on your card. If you are not happy with your PCP, you can log in to your My CareSource account to choose a new doctor. You can change your PCP to another provider who participates with CareSource. You can change up to once a month, if needed.
For the names of the PCPs that serve CareSource members, please use the Find a Doctor/Provider tool.
How can I get help in another language or format?
Call Member Services. We can get someone who can sign or speak your language to help you talk with us or your doctor. And it is free.
We can also give you some printed materials in some other languages, including alternate formats like audio, large print or braille. Let us know. We can help.
Member Services: 1-855-475-3163 (TTY: 1-800-750-0750 or 711), 8 a.m. to 8 p.m., Monday – Friday.