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Advocates Concerned About Confusion as MyCare Ohio Kicks In on January 1

FOR IMMEDIATE RELEASE:                            CONTACT: John Arnold, 614-456-0060 ext. 237
December 15, 2014

 Advocates Concerned About Confusion as MyCare Ohio Kicks In on January 1

 Nearly 100,000 Ohioans who are dually eligible for Medicare and Medicaid are currently enrolled in managed care plans of MyCare Ohio, the demonstration to integrate and coordinate their care, for their Medicaid services.

 On January 1, 2015, MyCare Ohio enrollees will begin also receiving their Medicare services through their MyCare plan, unless they choose to opt out. Enrollees who have not made a choice have already been assigned.  Ohio Consumer Voice for Integrated Care (OCVIC) is extremely concerned about widespread confusion among many enrollees about their choices with respect to their Medicare services.

 In the past 2 months, enrollees received notices from the state explaining their options. But these notices are way too complicated for the average person to understand – let alone older adults with cognitive impairments. OCVIC is fearful that enrollees will realize what’s happened only if they encounter interruptions of current Medicare services, including doctor visits and prescription drugs. MyCare Ohio Enrollees Need to Understand Their Choices and that Help is Available

 MyCare Ohio enrollees can choose to continue receiving their Medicare services through the traditional program or a Medicare Advantage plan. But, to avoid having their Medicare automatically switched into their MyCare Ohio plan, enrollees have to take active steps to “opt out.” The problem is, many enrollees are confused.

 In order to make a good decision about MyCare Ohio for themselves, people need to know:

  • Will I be able to continue to see my doctors and other community service providers?
  • Are my medications covered?
  • Are there any value added benefits?

 Consumers must also understand that MyCare Ohio plans are managed care organizations.  That means that in order to receive the most benefit,

  • All of their providers will eventually need to be members of their plan’s network,
  • Members must have a referral to see most specialty doctors, and
  • Members must have an authorization from the insurance plan for most services. 

 These requirements may be very different for people who participate in the traditional Medicare fee-for-service program.

 Certainly the coordination of all medical and home and community based services offered by MyCare Ohio is a benefit that may help a lot of people as well as having one insurance plan and member ID card that covers everything.   But, making MyCare work is an individual decision. In this case, one size does not fit all.

 For help in understanding your choices, enrollees can contact:

Your Local Area Agency on Aging

OSHIIP

 Talk to Your Providers:

MyCare Ohio beneficiaries should talk with their doctors and other providers to make sure that they will still be able to serve them after January 2015. For more information about their plans and services they should call their MyCare insurance plan.  The telephone numbers for each plan is listed below.

  • Buckeye Community Health Plan             1-866-246-4358
  • CareSource                                                         1-855-475-3163
  • UnitedHealthcareConnected                      1-877-542-9236
  • Aetna                                                                    1-855-364-0974
  • Molina                                                                  1-855-665-4623

 Providers who have additional questions about reimbursement, becoming a contracted provider, or how MyCare Ohio will work for their patients or clients should contact each plan’s provider service.  These numbers are listed below.

  • Buckeye Community Health Plan              1-866-296-8731
  • CareSource                                                         1-800-488-0134
  • UnitedHealthcare Connected                     1-800-600-9007
  • Aetna                                                                    1-855-364-0974
  • Molina                                                                  1-855-322-4079

 Understanding MyCare Ohio is a challenge for most people and if this new demonstration is going to work in Ohio, we must make sure that it does no harm to our most vulnerable populations that are mandated to participate. 


Consumers Need to Know:

1. MyCare Ohio members can add or remove coordination of their Medicare services every month.  They must continue to have their Medicaid services coordinated by their MyCare plan.

2. There are benefits and potential drawbacks to having MyCare Ohio coordinate your Medicare services. 

3.  Free help is available in your community to help you to understand your choices. Contact your local Area Agency on Aging or OSHIIP. 

Your doctors and other providers may be confused about whether they can treat you, if you are in MyCare Ohio. Talk to your providers and have them call your plan’s Provider Services to resolve whether they can continue as your provider.

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