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Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Dual Options 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 Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Select Counties in Ohio. The overall rating for this plan is not yet available for 2025.
It's important to know that Molina Dual Options 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:
Molina Dual Options 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 Molina Dual Options 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 Molina Dual Options 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 Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan)
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Drug Coverage
The Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan) has a $0 deductible for prescription drugs. If you qualify for the low-income subsidy (LIS), you will pay $0 for your Part D drugs. In the initial coverage phase, you will pay the costs for drugs in each tier until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Molina Dual Options MyCare Ohio plan offers a wide range of benefits with no copay for many services. This includes no copay for ambulance services, emergency services, primary care, home health services, dialysis, medical equipment, diagnostic and radiological services, and skilled nursing facility services. The plan also offers coverage for hearing and vision services, including routine eye exams, eyewear, and hearing aids, and a comprehensive dental plan. Additional benefits include coverage for outpatient services, partial hospitalization, and home infusion services. The plan also provides coverage for acupuncture, over-the-counter items, and a meal benefit. However, it's important to note that some services like cardiac rehabilitation, and certain types of hearing aids are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with prior authorization required. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered. However, Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient substance abuse services are partially covered, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan) with prior authorization required. The cost of services is not mentioned.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered. All 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.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Molina Dual Options MyCare Ohio plan. There is no copay or coinsurance for Emergency Services and Urgently Needed Services, but Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Molina Dual Options MyCare Ohio plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services with no copay and no coinsurance for Occupational Therapy and Physical Therapy. Chiropractic Services are partially covered, but not Routine Chiropractic Care. Mental Health Specialty Services and Psychiatric Services are partially covered, but not individual or group sessions. Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero-dollar preventive services, Health Education, Nutritional/Dietary Benefit (up to 12 visits), Additional Sessions of Smoking and Tobacco Cessation Counseling (up to 8 visits), Fitness Benefit, Remote Access Technologies, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. Annual Physical Exams, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing services include routine hearing exams and fitting/evaluation for hearing aids with no copay, and prescription hearing aids (all types) covered every 4 years for conventional and 5 years for digital or programmable. Prescription hearing aids - inner ear, outer ear, and over the ear, as well as OTC hearing aids, are not covered.
Vision Services See details
The Molina Dual Options MyCare Ohio plan covers vision services, including eye exams and eyewear. Routine eye exams are covered once every 12 months for members under 21 and over 59, or once every 24 months for members 21-59. Contact lenses, eyeglass lenses, and eyeglass frames are covered once every 12 months for members under 21 and over 59, or once every 24 months for members 21-59. Upgrades are not covered.
Dental Services See details
The Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan) covers a range of dental services, 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. Oral exams are covered annually for those 21 and over and twice annually for those 20 and under, dental x-rays are covered every six months, and other diagnostic dental services, restorative services, endodontics, periodontics, prosthodontics (fixed), and oral and maxillofacial surgery are unlimited.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan), including Medicare Part B Insulin Drugs; however, Medicare Part B Chemotherapy/Radiation Drugs are not covered. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan). There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Other 1 for Durable Medical Equipment (Incontinence Garments), and Prosthetics/Medical Supplies, with no copay or coinsurance. However, Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan), 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 covered services.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance, but authorization is required. Non-Medicare-covered Home Health Services include Personal Care Services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan). The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Molina Dual Options MyCare Ohio plan. The plan also covers additional days beyond Medicare-covered and non-Medicare-covered stays for SNF, with no copay for any services.
Other Services See details
The Molina Dual Options MyCare Ohio plan covers acupuncture with prior authorization, and also provides over-the-counter items with a $20 monthly maximum. The plan also covers a meal benefit with prior authorization, and offers a variety of additional services, including private duty nursing services with a limit of 16 hours per day. Some services are not 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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