Potential for Contract Termination
Buckeye Health Plan – MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. Enrollment in Buckeye Health Plan – MyCare Ohio (Medicare-Medicaid Plan) depends on contract renewal.
If one or more of the following situations happens, Medicare or Ohio Medicaid must end your membership with Buckeye Health Plan – MyCare Ohio (Medicare-Medicaid Plan):
- There is a break in your Medicare Part A and Part B coverage.
- You no longer qualify for Ohio Medicaid. Our plan is for people who qualify for both Medicare and Ohio Medicaid.
- You do not pay the amount needed for you to qualify for benefits (medical spend down).
- You move out of our service area.
- You go to jail.
- You lie about or do not tell us information about other insurance you have for drugs.
If we learn from Medicare and/or Ohio Medicaid that one or more of the following has occurred, we will disenroll you from our plan with permission from Medicare and Ohio Medicaid:
- You give us incorrect information on purpose when you are enrolling in our plan and that information made you eligible for our plan.
- You always behave in a way that bothers others and makes it difficult for us to provide medical care for you and other members of our plan.
- You let someone else use your ID card to get medical care.
- If we end your membership because of this reason, Medicare may turn your case over to the Inspector General.
Your Rights Upon Disenrollment
If we ask Medicare and Medicaid to end your membership in our plan, we must tell you our reasons in writing. We must also explain how you can make a complaint about our request to end your membership. See the Appeals and Grievances section of this website for information about how to make a complaint.