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Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Better Health of Ohio, 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 Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Cincannati Metro, Columbus Metro, Toledo Metro. The overall rating for this plan is not yet available for 2025.
It's important to know that Aetna Better Health of Ohio, 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:
Aetna Better Health of Ohio, 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 Aetna Better Health of Ohio, 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 Aetna Better Health of Ohio, 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 Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan) plan has an enhanced alternative drug benefit. This plan has no deductible for prescription drugs. During the initial coverage phase, you will pay the costs for drugs in each tier until your total drug costs reach $2,000. After your yearly out-of-pocket drug costs reach $2,000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan) plan offers a wide range of benefits with no copay, including ambulance services, emergency services, primary care services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, routine eye exams, eyewear, routine hearing exams, fitting/evaluation for hearing aids, Dialysis Services, Medical Equipment, Diagnostic and Radiological Services, Home Health Services, and Skilled Nursing Facility (SNF) services. Additionally, this plan covers inpatient and outpatient services, preventive services, dental services, home infusion bundled services, cardiac rehabilitation services, and other services. This plan provides coverage for a variety of services, but it's important to note that some services require prior authorization. For instance, while the plan covers hearing aids and vision services, it does not cover prescription hearing aids for the inner ear, outer ear, and over-the-ear, or OTC hearing aids, nor does it cover upgrades for vision. While there is coverage for outpatient and substance abuse services, individual and group sessions are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, as well as additional days for each. 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, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services, are covered. Outpatient substance abuse services are partially covered, with individual and group sessions for outpatient substance abuse not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, but requires prior authorization. There is no information about the cost of this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by this plan. All ambulance services are covered with no copay and no coinsurance, but ground and air ambulance services are not covered. Transportation Services are covered for plan-approved health-related locations, with 30 round trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, are covered with no copay and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. This plan offers no copay or coinsurance for Occupational Therapy Services, and Physical Therapy and Speech-Language Pathology Services. Mental Health Specialty Services and Psychiatric Services are partially covered, with Individual and Group Sessions for these services not covered. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include coverage for Medicare-covered preventive services, additional preventive services, kidney disease education services, and other preventive services; however, annual physical exams, in-home safety assessments, and several other services are not covered. Health education, additional sessions of smoking and tobacco cessation counseling (42 visits), fitness benefits (memory fitness), remote access technologies, glaucoma screening, barium enemas, digital rectal exams, and EKG following Welcome Visit are covered.
Hearing Services See details
Hearing services include routine hearing exams and fitting/evaluation for hearing aids, with no copay or coinsurance, and prescription hearing aids (all types) with up to two visits not more than once every 4 years for conventional and 5 years for digital or programmable. This plan does not cover prescription hearing aids for the inner ear, outer ear, and over-the-ear, or OTC hearing aids.
Vision Services See details
Vision services include routine eye exams, eyewear, and upgrades. Routine eye exams are covered with no copay, once per 12-month period for members under 21 and over 59 years of age, or once per 24-month period for members 21 through 59 years of age. Eyewear includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, which are all covered once per 12-month period for members under 21 and over 59 years of age, or once per 24-month period for members 21 through 59 years of age, with no copay. 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, maxillofacial prosthetics, implant services, prosthodontics, fixed, oral and maxillofacial surgery, and orthodontics. Oral exams and dental x-rays are covered up to once every six months, while other diagnostic dental services, restorative services, endodontics, periodontics, prosthodontics, fixed, and oral and maxillofacial surgery have no limits.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan), including Medicare Part B Insulin Drugs. Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis services are covered by Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan). There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits, including Durable Medical Equipment (DME), are covered with no copay or coinsurance, and require authorization. Prosthetics/Medical Supplies - Non-Medicare benefits are covered with no copay or coinsurance, but also require authorization, while Diabetic Equipment is partially covered, with Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts not being covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, 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 that are covered.
Home Health Services See details
Home Health Services are covered by Aetna Better Health of Ohio, MyCare Ohio. There is no copay or coinsurance for home health services, but authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan), including additional days beyond Medicare-covered and non-Medicare-covered stays. Prior authorization is required, and there is no copay for the day of discharge.
Other Services See details
Other Services includes acupuncture, over-the-counter items, a meal benefit, and additional services. Acupuncture is covered with prior authorization, and there are no limits on the number of treatments. Over-the-counter items are covered up to $35.00 per month, and a meal benefit is covered for chronic illnesses. Several additional services are covered, including private duty nursing services up to 16 hours per day, and other services such as home modification, home medical equipment, and more.
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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