Those who meet the rules to join in our plan for Ohio Medicaid, they will get the following benefits from our health plan:
- Inpatient hospital, rehabilitation, and nursing facility stays. Home health, DME, physician services, routine vision, dental, and hearing services. Some members get services through managed care plans or fee-for-service Ohio Medicaid.
- Regular traditional Ohio Medicaid also covers behavioral health services from the Ohio Department of Mental Health and Addiction Services. Members can get these benefits through fee-for-service Ohio Medicaid; our Medicare-Medicaid Plan will offer these benefits in addition to traditional Ohio Medicaid covered services. Behavioral health services include one-on-one or group meetings, crisis intervention, intensive outpatient and inpatient mental health services, partial hospitalization, and community psychiatric supportive treatment.
- Waiver programs. Waiver programs offer limited coverage, but are targeted to eligible individuals for:
- Adaptive/assistive devices
- Adult day health care
- Emergency response systems
- Home-delivered meals
- Home modifications
- Nursing facility care
- Nursing services
- Personal care assistance services and/or skilled therapy services
- Respite care
- Supplemental transportation
These waivers provide members on Ohio Medicaid with certain services that allow them to get long-term care outside of a hospital or nursing facility. Those who meet the rules to join have been understood as having a physical or emotional need or skilled level of care. Without the services available through the waiver benefit, these individuals are at risk for hospital or long-term nursing home placement.
MyCare Ohio will include all of the services that are covered in the following home and community-based Medicaid waivers: PASSPORT, Choices, Assisted Living, Ohio Home Care, and Transitions Carve-out. If you are getting services in one of these waivers at the time you joined in MyCare Ohio, you can continue to get those same services by your same providers for a specified time.
Finally, Ohio Medicaid covers drugs for all recipients except those who are able to join in Medicare Part D; Part D-eligible recipients can only get Ohio Medicaid coverage for medications that are not covered by Medicare Part D.