03/26/2026

MyCare Ohio Continuity of Care Requirements Apply Regardless of Network Status

A recent concern raised with the Ohio Department of Medicaid points to assisted living providers directing residents to enroll in a single MyCare Ohio plan. While providers may choose which plans to contract with, that decision does not change a plan’s obligation to pay for services already in place. Under the MyCare Ohio provider agreement, individuals who transition from Medicaid fee-for-service into MyCare must be able to continue receiving services from their existing assisted living or nursing facility provider—even if that provider is out of network. This requirement reflects that the setting is both the person’s home and their provider, reinforcing continuity and stability in care.

There is no end date tied to this requirement. As long as the individual continues to meet the level of care, the MyCare plan must reimburse the provider at the Medicaid fee-for-service rate. This applies whether the individual actively selects a plan or is auto-assigned. Providers should ensure residents and families receive accurate information about their options and protections during enrollment, particularly as MyCare expands into additional counties and more individuals become eligible.

Access the MyCare Ohio provider agreement (see Table D.1, assisted living section) near the bottom of the document for full details.