Per CMS's most recent managed care enrollment data, report year 2024, Ohio Medicaid covered 2,719,479 members in managed care across 13 plans: 7 statewide comprehensive MCOs under the mainstream Next Generation program, 5 MyCare Ohio Opt-Out plans for dual-eligibles, and one small PACE plan (McGregor PACE, Cuyahoga County). This report-year roster predates the 2026 Next Generation MyCare Ohio transition to a new Fully Integrated Dual-Eligible Special Needs Plan model.
Ohio delivers most Medicaid coverage through the Next Generation managed care program, live since July 1, 2022. Seven managed care organizations hold statewide comprehensive MCO contracts (AmeriHealth Caritas, Anthem, Buckeye Community Health Plan, CareSource, Humana, Molina Healthcare of Ohio, and UnitedHealthcare Community Plan), with CareSource by far the largest at 1,191,420 of the program's 2,634,788 mainstream-MCO enrollees per CMS's 2024 data. Separately, MyCare Ohio serves Ohioans dually eligible for Medicare and Medicaid through an integrated managed care model; CMS's 2024 data reflects MyCare's prior 5-plan Opt-Out roster (Aetna, Buckeye, CareSource, Molina, UnitedHealthcare, 85,027 combined enrollees), already superseded by Next Generation MyCare Ohio, a Fully Integrated Dual-Eligible Special Needs Plan (FIDE-SNP) model that launched January 1, 2026 in the original 29 demonstration counties with statewide rollout completed April 1, 2026 under a new 4-plan roster (Anthem, Buckeye, CareSource, and Molina), with Aetna and UnitedHealthcare no longer participating in MyCare Ohio.
For Ohioans dually eligible for Medicare and Medicaid, long-term services and supports, including nursing facility care and home- and community-based waiver services, are coordinated directly through their MyCare Ohio plan. For the broader non-dual Medicaid population, LTSS remains outside the 7 mainstream Next Generation MCOs: it is delivered through standalone 1915(c) HCBS waiver programs, most administered on a fee-for-service, case-managed basis, including the PASSPORT Waiver (Ohio's largest, serving older adults), Ohio Home Care Waiver, Individual Options (IO) Waiver, Level One Waiver, Assisted Living Waiver, Ohio Choices Waiver, Self Empowered Life Funding (SELF) Waiver, and the Transitions DD and Transitions II Aging Carve-Out waivers.
Partially integrated into managed care
For the general Medicaid population, behavioral health is included within each mainstream MCO's comprehensive capitated benefit alongside medical and other services, not carved out to a separate statewide vendor. The one real, statewide carve-out is OhioRISE (Resilience through Integrated Systems and Excellence), launched July 1, 2022 for a specific subpopulation: children and youth with the most complex behavioral health needs. OhioRISE enrollees receive their behavioral health benefit exclusively through the single statewide OhioRISE plan, while medical, dental, and vision coverage continues through one of the 7 mainstream MCOs or fee-for-service.
Carved out
Dental coverage is embedded within each mainstream MCO's own comprehensive benefit rather than delivered through a single statewide dental vendor; individual MCOs subcontract their own dental network administration (LibertyDental Plan and DentaQuest are both active as MCO-level dental subcontractors in Ohio), so the specific vendor a member sees depends on which MCO they're enrolled with.
Gainwell Technologies has served as Ohio Medicaid's single statewide pharmacy benefit manager since October 1, 2022, replacing per-MCO pharmacy benefit administration.
Non-emergency medical transportation (NEMT) is brokered separately by each MCO rather than through one statewide vendor; active Ohio Medicaid NEMT brokers include Veyo, ModivCare, MTM, and Provide A Ride, with credentialing and access varying by which broker(s) a given MCO or fee-for-service population routes through.
Gainwell Technologies operates as Ohio Medicaid's fiscal intermediary, processing and paying fee-for-service claims through the state's Medicaid Management Information System, in addition to its role as pharmacy benefit manager. ODM's Provider Network Management (PNM) module serves as providers' single point for enrollment, centralized credentialing, and self-service.
Last updated: Sep 22, 2026
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