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Humana Healthy Horizons: Ohio Medicaid

Welcome to Humana Healthy Horizons®. With us, you get a Medicaid plan that does more. Like more rewards, more everyday benefits, and more help and support to make your life easier—so you have more time to focus on what you love.

Mother plays with son outside

You can pick flowers.

You can pick your friends.

And you can pick a health plan.

When you first qualify for Medicaid, you may be assigned a health plan, but you don’t have to keep it. You have the right to pick a different health plan and switch to it during the first 90 days of your enrollment.

Pick Humana Healthy Horizons in Ohio. We care about our members’ whole health journey and aim to help them reach their best health.

Helping keep our members in their best health is what human care is all about.

Learn more at Humana.com/HealthyOhio.

Ohio Department of Medicaid Next Generation of Managed Care program

The Ohio Department of Medicaid (ODM) designed its Next Generation Medicaid program to help make sure Medicaid recipients in Ohio get the care they need when they need it.

In 2022, ODM implemented two key phases:

  • On July 1, ODM implemented OhioRISE (Resilience through Integrated Systems)
  • On October 1, ODM implemented the Single Pharmacy Benefit Manager (SPBM)

To help ensure a smooth transition to the Next Generation Medicaid program, ODM will launch the final phase on Feb. 1, 2023.

Need help?

ODM is committed to ensuring there is no disruption in services for Medicaid members

In 2022, managed care members were given the chance in 2022 to pick a Next Generation managed care plan, such as Humana Healthy Horizons in Ohio.

If you picked a Next Generation managed care plan, like Humana Healthy Horizons, you will continue getting coverage through your current managed care plan until Feb. 1, 2023.

If you picked a managed care plan that currently offers coverage in Ohio, your coverage with your new plan will go into effect on Dec. 1, 2022.

If you are newly eligible for managed care, currently in Medicaid fee-for-service but not enrolled in a managed care plan, and/or have a gap in eligibility of more than 91 days, you will get care paid for through Medicaid fee-for-service until Feb. 1, 2023, at which time you will be transitioned to an Ohio Medicaid Next Generation plan, such as Humana Healthy Horizons in Ohio.

Medicaid recipients who choose Humana Healthy Horizons in Ohio can expect:

  • To have their coverage with us become effective on Feb. 1, 2023
  • The full complement of Medicaid benefits you get today
  • To get key health plan information, such as your member ID card, in the mail between 30-45 days of your effective date

Select your Ohio Medicaid Next Generation Managed Care Plan now

Apply for Medicaid

To apply for Medicaid in Ohio:

The Humana Healthy Horizons in Ohio difference

Everyone should have a health ally. We’re here to help you work toward your best health.

Humana Healthy Horizons in Ohio provides healthcare services to eligible Ohio residents, including:

  • Individuals who meet income requirements
  • Individuals who are pregnant
  • Infants
  • Children
  • Older adults
  • Individuals with disabilities

With Humana Healthy Horizons in Ohio, you get the coverage you need and more, including access to:

  • Go365 for Humana Healthy Horizons®, a program that rewards you for completing healthy activities
  • Health coaches and programs
  • Specialized care management programs

For Humana Healthy Horizons in Ohio members, all pharmacy services are covered by Gainwell, Ohio Medicaid’s Single Pharmacy Benefit Manager (SPBM). Gainwell covers all Medicaid-covered, medically necessary prescription and over-the-counter (OTC) medications.

We do our best to give our members what they need plus things they didn’t even know they needed. We call that human care.

Map of Ohio counties covered by Humana Medicaid

Map of Ohio counties covered by Humana Medicaid

Region 1 (West) counties include:
Adams, Allen, Auglaize, Brown, Butler, Champaign, Clark, Clermont, Clinton, Crawford, Darke, Defiance, Fulton, Greene, Hamilton, Hancock, Hardin, Henry, Highland, Logan, Lucas, Marion, Mercer, Miami, Montgomery, Ottawa, Paulding, Preble, Putnam, Sandusky, Seneca, Shelby, Van Wert, Warren, Williams, Wood, Wyandot

Region 2 (Northeast) counties include:
Ashland, Ashtabula, Carroll, Columbiana, Coshocton, Cuyahoga, Erie, Holmes, Geauga, Harrison, Huron, Jefferson, Knox, Lake, Lorain, Mahoning, Medina, Portage, Richland, Stark, Summit, Trumbull, Tuscarawas, Wayne

Region 3 (Central/Southeast) counties include:
Athens, Belmont, Delaware, Fairfield, Fayette, Franklin, Gallia, Guernsey, Hocking, Jackson, Lawrence, Licking, Madison, Meigs, Monroe, Morgan, Morrow, Muskingum, Noble, Perry, Pickaway, Pike, Ross, Scioto, Union, Vinton, Washington

Region 1 (West):
Adams, Allen, Auglaize, Brown, Butler, Champaign, Clark, Clermont, Clinton, Crawford, Darke, Defiance, Fulton, Greene, Hamilton, Hancock, Hardin, Henry, Highland, Logan, Lucas, Marion, Mercer, Miami, Montgomery, Ottawa, Paulding, Preble, Putnam, Sandusky, Seneca, Shelby, Van Wert, Warren, Williams, Wood, Wyandot

Region 2 (Northeast):
Ashland, Ashtabula, Carroll, Columbiana, Coshocton, Cuyahoga, Erie, Holmes, Geauga, Harrison, Huron, Jefferson, Knox, Lake, Lorain, Mahoning, Medina, Portage, Richland, Stark, Summit, Trumbull, Tuscarawas, Wayne

Region 3 (Central/Southeast) include:
Athens, Belmont, Delaware, Fairfield, Fayette, Franklin, Gallia, Guernsey, Hocking, Jackson, Lawrence, Licking, Madison, Meigs, Monroe, Morgan, Morrow, Muskingum, Noble, Perry, Pickaway, Pike, Ross, Scioto, Union, Vinton, Washington

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Value-added benefits

Learn about the extra benefits and services available to Humana Healthy Horizons in Ohio members.

Documents & forms

Find the documents and forms you need, including your Member Handbook.