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Ohio Medicaid: Eligibility and application information

Before the end of the year, Ohio Medicaid’s next generation managed care plans will provide a more personalized approach to support your healthcare needs. Ohio Medicaid recipients are encouraged to select their next generation managed care plan now. Humana Healthy Horizons® in Ohio is one of these options.

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Keep your information current with Ohio Medicaid/Ohio Benefits

Keep your address and full contact information up to date with Ohio Medicaid and/or Ohio Benefits. From time to time, they will send you important health information. They also need your information to make sure you remain eligible for Medicaid benefits. If you don’t keep your information current, your benefits may stop.

To update your information:

  • Call the Ohio Medicaid Hotline at 800-324-8680
  • Log into your account via Ohio Benefits

Helping you on your way to good health

We designed Humana Healthy Horizons in Ohio to provide you with the care and support you need—so you have more time to focus on what you love.

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.

Humana Healthy Horizons in Ohio is proud to partner with the Ohio Department of Medicaid (ODM) to provide coverage to Ohio residents eligible for Medicaid.

Why Choose Humana Healthy Horizons?

Now more than ever, your health and healthcare coverage are important. Humana Healthy Horizons makes available to Ohio Medicaid members access to the high-quality healthcare coverage you want and extras you need.

Important dates

On July 1, OhioRISE will begin to provide coordination and specialized services to help children and youth with behavioral health needs who receive care across multiple systems.

In October 2022, Gainwell Technologies will begin administering pharmacy benefits for all Medicaid recipients in Ohio. If you are enrolled in a health plan, your previous pharmacy benefits will remain the same. You do not have to do anything.

During the last three months of 2022, ODM will complete the launch of its Next Generation Medicaid program. This launch will include Humana Healthy Horizons in Ohio beginning to service Ohio Medicaid recipients.

Between now and then, if you choose Humana Healthy Horizons in Ohio as your health plan, you will continue getting the full complement of Medicaid benefits you get today, and:

  • The Ohio Medicaid Enrollment Center (or Ohio Benefits) will record your choice
  • Your choice will be effective when ODM completes the launch of its Next Generation Medicaid program
  • Around 30-45 days prior to Humana beginning operations, you will get in the mail your member ID card, health plan information, and your official start date of coverage

Learn more about Ohio Medicaid’s next generation managed care plans

To check the status of your request to enroll in Humana Healthy Horizons in Ohio:

  • Call the Ohio Medicaid Hotline at 800-324-8680
  • Log into your account via Ohio Benefits

Apply for Medicaid

To apply for Medicaid in Ohio:

Enrollment

After enrolling in a plan, [you can try it out through November 30, 2022.] If you want to switch to a different health plan, you can. No questions asked. After November 30, you will remain enrolled in the plan, as long as you are eligible for Medicaid. This is called the “lock-in” period.

ODM will notify you if you are a mandatory Medicaid enrollee required to enroll in a plan. If you do not enroll in a plan, ODM will assign you to a plan.

How to change your plan

If you are already enrolled in a plan and want to change to a different plan:

After November 30, if you want to change to a different plan, you must meet 1 of the following requirements:

  • You have been a member of your current plan for 3 months or less, or
  • You’re having problems finding the care you need

If you believe you meet 1 of the above requirements:

Disenrollment

If you are no longer eligible for Medicaid, you will be disenrolled from your health plan. You can lose Medicaid eligibility for a number of reasons, such as if your income level changes. We will notify you in writing if you lose your Medicaid eligibility and no longer have coverage through Humana Healthy Horizons in Ohio.

You also can be disenrolled from Humana Healthy Horizons in Ohio if you:

  • Abuse or harm health plan members, providers, or staff
  • Become eligible for Medicare
  • Do not fill out forms honestly or do not give true information (commit fraud)
  • Lose your Ohio Medicaid eligibility
  • Stay in a nursing home for more than 30 days in a row

If you become ineligible for Ohio Medicaid, all your services may stop. If this happens, call the Medicaid Consumer Hotline at 800-324-8680 (TTY: 711), Monday – Friday, 7 a.m. – 8 p.m., and Saturday, 8 a.m. – 5 p.m., Eastern time.

Get more information

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