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Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by Centene Corporation available for enrollment in 2025 to people living in CL, CU, FU, GE, GR, LA, LO, LU, ME, MO, OT, WO. The overall rating for this plan is not yet available for 2025.
It's important to know that Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)is a Medicare-Medicaide (MMP) plan. This means you can only enroll in this plan if you meet specific criteria for both medicare and medicaid. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)
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Drug Coverage
The Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) has an enhanced alternative drug benefit. The plan has a $0 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $0 for your Part D drugs. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. After you spend $2000 out-of-pocket, you will enter the catastrophic coverage phase and pay nothing for your covered drugs.
Additional Benefits
The Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) offers a wide range of benefits, including inpatient and outpatient services, with prior authorization often required. Many services have no copay, such as ambulance, emergency, and home health services, along with certain primary care, preventive services, hearing, medical equipment, and diagnostic services. Dental services are covered, along with home infusion and dialysis services. The plan also covers transportation to health-related locations, routine hearing and vision exams, and over-the-counter items up to $25 per month. However, it's important to note that certain services are not covered, such as cardiac rehabilitation, and some services may have limitations.
Inpatient Hospital See details
Inpatient Hospital benefits, including services not usually covered by Medicare plans, are covered, with prior authorization required; however, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric is not covered. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services, are covered; however, individual and group sessions for outpatient substance abuse are not covered. Prior authorization is required for all outpatient services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan). Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered with no copay or coinsurance, but ground and air ambulance services are not covered. Transportation services to a plan-approved health-related location are covered for up to 30 one-way trips per year via rideshare services or medical transport, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan), with no copay and no coinsurance for Emergency Services and Urgently Needed Services. Worldwide Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services have no copay and no coinsurance, while Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, Individual Sessions for Psychiatric Services, and Group Sessions for Psychiatric Services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar preventive services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, with no copay or coinsurance; however, annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, and home and bathroom safety devices and modifications are not covered. The plan also covers fitness benefits and remote access technologies (including Web/Phone-based technologies and Nursing Hotline).
Hearing Services See details
Hearing services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids, with no copay or coinsurance. Prescription hearing aids (all types) are covered for up to 2 visits, not more than once every 4 years for conventional and 5 years for digital or programmable, but inner ear, outer ear, and over-the-ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams, eyewear, and upgrades. Routine eye exams are covered once per 12-month period for members under 21 and over 59 years of age, or per 24-month period for members 21 through 59 years of age. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are covered once per 12-month period for members under 21 and over 59 years of age, or per 24-month period for members 21 through 59 years of age. Upgrades are not covered.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics. The plan covers oral exams annually for those 21 and over and twice annually for those 20 and under, dental x-rays every six months, and prophylaxis (cleaning), fluoride treatment, and other preventive dental services once per year, with other services covered as described.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan), including Medicare Part B Insulin Drugs. However, Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered with this plan. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits, including Durable Medical Equipment and Prosthetics/Medical Supplies - Non-Medicare benefits, are covered with no copay and no coinsurance, but Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. Other 1 for Durable Medical Equipment, specifically Incontinence Garments, is covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Buckeye Health Plan - MyCare Ohio, but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for the services covered.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan). Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan). This plan covers additional days beyond Medicare-covered, and non-Medicare-covered stays.
Other Services See details
The Buckeye Health Plan - MyCare Ohio plan covers acupuncture with prior authorization, and covers over-the-counter items up to $25 per month. The plan does not cover meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services. Private Duty Nursing Services, and Other 1-17 benefits are covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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