EAST CENTRAL

Ashland
Carrol
Holmes
Portage
Richland
Stark
Summit
Tuscarawas
Wayne

SOUTH WEST

Adams
Brown
Butler
Clermont
Clinton
Hamilton
Highland
Warren

WEST CENTRAL

Champaigne
Clark
Darke
Greene
Miami
Montgomery
Preble
Shelby

CENTRAL

Crawford
Delaware
Fairfield
Fayette
Franklin
Hocking
Knox
Licking
Logan
Madison
Marion
Morrow
Perry
Pickaway
Pike
Ross
Scioto
Union

NORTH EAST

Ashtabula
Cuyahoga
Erie
Geauga
Huron
Lake
Lorain
Medina

N. EAST CENTRAL

Columbiana
Mahoning
Trumbull

NORTH WEST

Allen
Auglaize
Defiance
Fulton
Hancock
Hardin
Henry
Lucas
Mercer
Ottawa
Paulding
Putnam
Sandusky
Seneca
Van Wert
Williams
Wood
Wyandot

SOUTH EAST

Athens
Belmont
Coshocton
Gallia
Guernsey
Harrison
Jackson
Jefferson
Lawrence
Meigs
Monroe
Morgan
Muskingum
Noble
Vinton
Washington

 

 


It is very important that you know and understand the benefits you are entitled to. Please review this section to get you aquainted with basic information that will help you understand your coverage...

Please read Carefuly and go over this Frequent Asked Questions. They may help you understand your benefits.

PLease dont hesitate to contact our Ohio Managed Care Enrollment Center at (800) 605-3040, Monday - Friday 8:00 am to 8:00 pm to have any other question or concern answered by one of our Enrollment Counselors. You may also want to use our online Contact Form.

Who Is Eligible ?

What is an MCP ?

In an MCP...

Basic Services

How do I Select and MCP ?

Can I Change My MCP ?

Helpful Hints

Your Rights

Your Responsibilities

Using the Emergency Room

 

Who is Eligible ?
  • If you receive health care coverage through Healthy Start or Healthy Families, these changes will affect the way you currently receive your health care services.

  • You will still receive all of the health care services that are covered by Medicaid, however, these services will be provided to you through a Managed Care Plan

  • If you do not choose a Managed Care Plan, one will be chosen for you

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WHAT IS AN MCP ?

Managed Care Plans (MCPs) are health care companies. MCPs work with certain doctors and hospitals. These doctors agree to give you care and help you get the medical attention you need from other health care providers.

 

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IN AN MCP...
  • You will choose one doctor for yourself.

  • You may also choose one doctor for each of your children.

  • The doctor you choose is called your Primary Care Physician or PCP. Before getting most health care services, you will call your PCP.

  • The doctor you choose must be a doctor who is on your MCP's provider list.

  • You will get the same medically necessary services that the Medicaid Card offers. Many MCPs offer additional services that are not covered by Medicaid.

  • You will not get your medical card in the mail every month. Instead, you will get an MCP Member ID Card. Keep this card until your MCP sends you a new one.

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BASIC SERVICES

Your MCP will provide you with all the same services available with the Medicaid Card!

  • Prescriptions

  • Dental Care

  • Vision Care

  • Doctor Visits

  • Immunizations

  • Hospital, Emergency & Ambulance Services

  • Substance Abuse & Mental Health Services

  • Lab & X-Ray Services

  • Medical Supplies

  • Care for Pregnant Women

  • Home Health Care

  • And More

You may call the MCP's toll-free number and request a current copy of the MCP's member handbook and provider directory if you do not have one.

 

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HOW DO I SELECT AN MCP ?
  • Call the Managed Care Enrollment Center at (800) 605-3040.

  • Meet face-to-face with an Outreach & Education Counselor at the County Department of Job & Family Services.

  • Call to request an information packet by mail.

Remember: If you do not choose an MCP, one will be chosen for you.

 

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CAN I CHANGE MY MCP ?
  • You may change your MCP for any reason within the first three months of your initial selection.

  • You may change your MCP every year during your county's open selection month.

  • You may change your MCP if you have a "just cause" or for continuity of care.

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HELPFUL HINTS
  • Learn about your MCP choices.

  • Choose an MCP that meets your medical needs. (If you want to keep your doctor, check to see if your doctor is on the MCP's provider list.)

  • Choose a Primary Care Physician (PCP) for yourself. Choose the same or a different PCP for your child.

  • When possible, it is a good idea to go to or call your PCP before going to the emergency room. Your personal doctor or nurse may be able to solve your problem over the phone.

  • Read your Member Handbook. It has information about your health care and how to make a complaint if you are unhappy with your healthcare services. Your MCP will mail you a member handbook.

  • Always carry your MCP Member ID Card.

  • Call the Managed Care Enrollment Center with questions about managed care and MCPs. The number is (800) 605-3040.

  • You can also call the Managed Care Enrollment Center to find out how and when you can change your MCP, if necessary.

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YOUR RIGHTS
  • You have the right to a grievance process (file a complaint).

    • File your complaint with your MCP according to the guidelines in your Member Handbook.

    • If you cannot reach a resolution with your MCP then you should call the Managed Care Enrollment Center.

  • You have the right to change your doctor at any time and for any reason.

 

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YOUR RESPONSIBILITIES
  • Participate actively in your health care-obtain annual physical exams

  • Communicate with your doctor

  • Obtain immunizations

  • Obtain early and regular prenatal care

  • Keep your appointments

  • Follow emergency room guidelines as outlined in your MCP Member Handbook.

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USING THE EMERGENCY ROOM
  • For non-emergency conditions call your Primary Care Physician (PCP)

  • For serious conditions that are not life-threatening use Urgent Care

  • For life-threatening conditions use the Emergency Room

 

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Ohio Managed Care Enrollment Center

 

Call to speak with an Enrollment Counselor
Monday - Friday
8:00 a.m. to 8:00 p.m.
(800) 605-3040

 

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