Ohio Medicaid
Complete guide to Ohio Medicaid enrollment, managed care plans, and provider requirements
Enrollment Time
60-90 Days
MCOs
6 Plans
Timely Filing
120 Days
Model
Managed Care
Ohio Medicaid Overview
Ohio Medicaid serves nearly 3 million beneficiaries, with the vast majority enrolled in managed care plans. The state has fully implemented managed care statewide through partnerships with 6 major MCOs.
Key Ohio Features:
- • Statewide Managed Care: Nearly all beneficiaries in MCO plans
- • CareSource Dominance: Ohio-based CareSource is the largest plan
- • Behavioral Health Integration: BH services integrated into MCO plans
- • MyCare Ohio: Integrated care for dual eligibles
Provider Enrollment Process
Step-by-Step Ohio Medicaid Enrollment
1. Enroll with Ohio Department of Medicaid
Complete enrollment with the Ohio Department of Medicaid:
- • Submit online application through MITS (Medicaid Information Technology System)
- • Provide Ohio license, NPI, TIN, and supporting documentation
- • Complete required background checks and attestations
- • Processing time: 45-75 days
2. Contract with Managed Care Plans
After state enrollment, credential with MCOs:
- • All 6 MCOs operate statewide
- • Submit credentialing applications (most use CAQH)
- • Each plan has separate provider agreements
- • Processing time: 60-90 days per plan
Total Timeline
- • Ohio Medicaid enrollment: 45-75 days
- • MCO credentialing: 60-90 days per plan
- • Total: 105-165 days from start to billing
Ohio Medicaid Managed Care Plans
Note: All 6 MCOs operate statewide in Ohio. Most providers contract with 3-4 plans to maximize patient access.
Aetna Better Health of Ohio
Buckeye Health Plan (Centene)
CareSource
Molina Healthcare of Ohio
Paramount Advantage (ProMedica)
UnitedHealthcare Community Plan
Market share: CareSource (OH-based) has the largest enrollment, followed by Buckeye and Molina. Most providers contract with at least CareSource, Buckeye, and one other plan.
Behavioral Health Services
Ohio Medicaid Behavioral Health Coverage
Ohio has integrated behavioral health services into managed care plans. All MCOs cover comprehensive mental health and substance use disorder treatment.
Covered BH Services
- • Outpatient therapy (individual, group, family)
- • Psychiatric services and medication management
- • Intensive outpatient programs (IOP)
- • Partial hospitalization programs (PHP)
- • Residential treatment facilities
- • SUD treatment (all levels of care)
- • Peer recovery services
- • Crisis stabilization services
- • Assertive Community Treatment (ACT)
ODMHAS Certification
Behavioral health agencies must be certified by the Ohio Department of Mental Health and Addiction Services (ODMHAS) to bill Medicaid. This is separate from Medicaid enrollment.
Important Contacts
Ohio Department of Medicaid
ODMHAS (BH Certification)
General Information
1-877-275-6364
ODMHAS Website
MHA.Ohio.gov