Aetna Better Health of Ohio and UnitedHealthcare Community Plan are being removed from the MyCare Ohio program.

This change is happening as the Ohio Department of Medicaid (ODM) transitions to the “Next Generation MyCare Program.”

Here are the key details you need to know:

Effective Date of Change

• Both Aetna Better Health of Ohio and UnitedHealthcare Community Plan will no longer be MyCare Ohio plans effective January 1, 2026.

The Reason for the Change

• The Ohio Department of Medicaid (ODM) is reforming the dual-eligible program by launching the Next Generation MyCare Program beginning January 1, 2026.
• In November 2024, ODM announced the four managed care organizations (MCOs) that were awarded contracts to serve as the Next Generation MyCare plans:
  1. Anthem Blue Cross and Blue Shield
  2. Buckeye Health Plan (Currently in MyCare and will continue)
  3. CareSource (Currently in MyCare and will continue)
  4. Molina HealthCare of Ohio (Currently in MyCare and will continue)
• Aetna and UnitedHealthcare were not among the MCOs selected for this next generation of the program.

Impact on Providers

• Continuation of Claims Payment: Aetna and UnitedHealthcare are responsible for paying claims for services rendered through December 31, 2025. They will continue to process and pay claims for up to 365 days from the end of the year.
• New Contracts Needed: Providers who wish to continue serving MyCare members must ensure they are contracted and credentialed with the remaining Next Generation MyCare plans (Anthem, Buckeye, CareSource, and Molina).

Impact on Members

• No Loss of Coverage: Current MyCare Ohio members will not lose coverage due to this change.
• Action Required: Members currently enrolled with Aetna Better Health of Ohio or UnitedHealthcare Community Plan must select a new Next Generation MyCare plan for their coverage beginning January 1, 2026.
• Automatic Enrollment: If a member does not select a new plan during the open enrollment period (which is generally November 1–30), they will be automatically enrolled in one of the new Next Generation MyCare plans.

In summary, the removal of Aetna and UnitedHealthcare is part of Ohio’s statewide overhaul of its dual-eligible (Medicare/Medicaid) managed care program.