ODM Managed Care Member Transition and Enrollment Update

The Ohio Department of Medicaid hosted a series of listening sessions related to procurement implementation and provided updates on member transition enrollment. The transition enrollment to select from the seven new plans that will be effective on July 1 opened March 1. ODM’s transition enrollment encourages managed care members to actively select their MCO using a “choose or stay put approach.” If a current managed care member does not select a plan, they will remain on their current plan. If their current plan is Paramount, they will be transitioned to Anthem.

Members have seven managed care plans to choose from:

  1. Buckeye Community Health Plan
  2. CareSource
  3. Molina Healthcare
  4. UnitedHealthcare Community Plan
  5. AmeriHealth Caritas
  6. Humana, and
  7. Anthem Blue Cross and Blue Shield

Medicaid members can choose their plan by visiting the Ohio Medicaid Consumer Hotline Portal at members.ohiomh.com, or by calling the Ohio Medicaid Consumer Hotline at 800-324-8680.

Enrollment in the new Medicaid MCO will follow a rolling schedule.  If a Medicaid member selects a plan between March 1 and June 11, that plan will be effective July 1. If a Medicaid member selects a plan from June 12 to July 31, that plan will be effective August 1. Additionally, Medicaid members will have an extended open enrollment and will have the option to change plans from July 1 to November 30, 2022. If a Medicaid member selects a new plan during this time, they will start on the new plan the following month.

FFS Medicaid Pool: Any new Medicaid member enrolling from March 1 to June 30  will be in Fee-for-Service Medicaid and then assigned to a managed care plan for July 1. Providers may experience an increase in FFS billing to ODM from March to June 2022.

The slides from the relevant listening session are now available. As is currently the case, ODM will not be sending information to providers if Medicaid members change plans. Since Medicaid members will be able to change plans multiple times from July through the end of the year, our recommendation to organizations is to review your current 270/271 process and establish regular intervals to run this transaction to check eligibility, as this is the most reliable process for verifying clients’ Medicaid enrollment.