Credentialing with the New MyCare Plans: A Guide for Ohio Home Care Providers

What home care agencies and in-home service providers need to know about re-credentialing, member transitions, and protecting your reimbursement in 2026.

Every expansion wave means new members, and if you’re not credentialed and contracted with their plan before services begin, your claims won’t get paid.

Here’s what you need to know.

What Changed and Why It Matters for Home Care

The Ohio Department of Medicaid (ODM) launched Next Generation MyCare on January 1, 2026, transitioning from the legacy MyCare Ohio program to a Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) model. Two previous plans — Aetna Better Health of Ohio and United Healthcare Community Plan — exited the program entirely.

The four plans now serving members are:

• Anthem Blue Cross and Blue Shield (new to MyCare)
• Buckeye Health Plan (existing members only — not accepting new enrollees)
• CareSource
• Molina HealthCare of Ohio

For home care providers, this matters because Area Agencies on Aging (AAAs) coordinate in-home waiver services — personal care, transportation, home-delivered meals, homemaking, and more — but the MCOs are the payers. You must be contracted with whichever plan a member is enrolled in before submitting a claim for those services.

Aetna and United will continue to pay claims for dates of service through December 31, 2025, for up to 365 days. Those legacy claims still go to Aetna or United — submitting them to a new plan will get them denied.

The County Expansion: Know When Your County is Affected

This is the piece that can sneak up on home care providers. Members in counties newly added to Next Generation MyCare are attributed to one of the four plans on their expansion effective date. If you’re providing ongoing in-home services to a client in a newly covered county, their payer changes on that date — and your claims need to follow.

• Phase 1 – Jan. 1, 2026: 29 existing MyCare counties (Franklin, Hamilton, Cuyahoga, Summit, Montgomery, and others)
• Phase 2a – Apr. 1, 2026: Sandusky, Erie, Henry, Williams, Defiance, Paulding, Fayette, Fairfield, Licking, Ashtabula
• Phase 2b – May 1, 2026: Preble, Darke, Miami, Shelby, Champaign, Logan, Van Wert, Putnam, Hancock, Allen, Mercer, Auglaize, Hardin, Seneca, Huron, Wyandot, Crawford, Richland, Ashland, Marion, Morrow
• Phase 2c – Jun. 1, 2026: Ross, Vinton, Highland, Pike, Jackson, Gallia, Brown, Adams, Scioto, Lawrence
• Phase 2d – Jul. 1, 2026: Holmes, Tuscarawas, Carroll, Jefferson, Coshocton, Harrison, Belmont, Guernsey, Muskingum
• Phase 2e – Aug. 1, 2026: Hocking, Perry, Morgan, Noble, Monroe, Washington, Athens, Meigs, and remaining counties

Practical step: Pull your client list now. For any client in a Phase 2 county, identify their current coverage, confirm which Next Generation MyCare plan they will be or have been attributed to, and verify you are contracted with that plan before their phase goes live.

The Two-Step Credentialing Process

This is the most critical thing to understand. Credentialing for Next Generation MyCare has two separate steps — completing only one is not enough.

Credentialing is a two-step process for agency owners that includes both the PDM Module and contracting with the individual plans as well.

For more information on the credentialing process, register for the webinar here!

Key Contacts

• ODM Integrated Help Desk: 800-686-1516 | IHD@medicaid.ohio.gov
• ODM PNM Portal: medicaid.ohio.gov
• CareSource Provider Services: 800-488-0134
• Molina Provider Services: 855-322-4079
• Anthem Provider Contracting: 833-727-2170
• Buckeye Provider Contracting: 833-998-4892
• Ohio Medicaid Consumer Hotline (member plan questions): 800-324-8680

The Next Generation MyCare expansion doesn’t stop until August 2026. For home care providers, every new phase is a potential billing disruption if you’re not prepared. The credentialing steps are manageable — but they require action before your clients’ attribution changes, not after.