Medicare and Ohio Medicaid: MyCare Ohio and the Medicare Savings Programs

Some Ohioans qualify for both Medicare and Medicaid — often called being “dual eligible.” When that happens, Medicare pays first, and Ohio Medicaid may help with costs Medicare leaves behind, like premiums, deductibles and coinsurance, plus services Medicare does not cover at all, such as long-term care at home or in a nursing facility.

How Medicaid works for seniors in Ohio

Ohio Medicaid is administered by the Ohio Department of Medicaid, with eligibility handled through your county Department of Job and Family Services. Eligibility is determined by the state — not by an insurance agency — based on income and resources. You apply at benefits.ohio.gov, at your county JFS office, or by phone at 800-324-8680, the Ohio Medicaid Consumer Hotline.

MyCare Ohio, rebuilt for 2026

For a decade Ohioans with both Medicare and Medicaid in 29 counties were served by MyCare Ohio, a federal demonstration that combined the two programs in one Medicare-Medicaid plan. That demonstration ended December 31, 2025. On January 1, 2026 the Ohio Department of Medicaid launched Next Generation MyCare, built instead as a fully integrated dual-eligible special needs plan (FIDE-SNP): a Medicare Advantage plan and a Medicaid managed-care plan run by the same company, with one card, one care coordinator and one set of benefits that includes long-term services and supports. Four companies were chosen to run it: Anthem Blue Cross and Blue Shield, Buckeye Health Plan, CareSource and Molina Healthcare of Ohio. Phase one covered the 29 counties where MyCare already operated; the program was scheduled to expand to the rest of Ohio in phases between April 1 and August 1, 2026, which would make it statewide as of this writing. Because the timing of your county’s phase and the rules for keeping Original Medicare alongside the Medicaid side are set by the state, confirm your own situation with the Ohio Medicaid Consumer Hotline or OSHIIP before changing anything.

Programs that can lower your costs

• Medicare Savings Programs (MSPs) — QMB, SLMB and QI — pay the Part B premium ($202.90 in 2026) and, for QMB, Medicare’s deductibles, copays and coinsurance as well. A fourth, QDWI, pays the Part A premium for certain working people with disabilities. Ohio’s income and resource limits change each year; the Ohio Department of Insurance publishes a current guide (linked below). None of the four is subject to Ohio estate recovery, and you do not have to be on full Medicaid to qualify. Apply through Ohio Medicaid, and OSHIIP will help you fill in the application for free.
• Extra Help (Low-Income Subsidy) lowers what you pay for Part D premiums, deductibles and copays. If you qualify for an MSP or Medicaid you get Extra Help automatically; otherwise apply through Social Security.
• Next Generation MyCare plans and other Dual Special Needs Plans (D-SNPs) are Medicare Advantage plans designed for people with both Medicare and Medicaid; they coordinate the two programs, usually at $0 plan premium, and often add extras while keeping your Medicaid benefits intact.

Free, unbiased state counseling on all of this is available from OSHIIP — the Ohio Senior Health Insurance Information Program, part of the Ohio Department of Insurance — at 800-686-1578. When you are ready to talk through the Medicare side, we are here at (702) 706-6564.

How we help

We help you understand whether a MyCare or other dual plan is available and a good fit where you live, how a Medicare Savings Program and Extra Help could reduce your costs, and how to keep your Medicaid benefits working alongside Medicare. Eligibility decisions rest with the Ohio Department of Medicaid and CMS; our job is to make the Medicare side clear.

ECOS Medicare Solutions is a private insurance agency and is not connected with or endorsed by Ohio Medicaid, the Ohio Department of Medicaid, MyCare Ohio, or the federal Medicare program.