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CareSource MyCare Ohio (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CareSource 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 CareSource MyCare Ohio (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
CareSource MyCare Ohio (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by CareSource available for enrollment in 2025 to people living in Northeast, Northeast Central, East Central Ohio. The overall rating for this plan is not yet available for 2025.
It's important to know that CareSource 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:
CareSource 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 CareSource 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 CareSource 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 CareSource MyCare Ohio (Medicare-Medicaid Plan)
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Drug Coverage
The CareSource MyCare Ohio (Medicare-Medicaid Plan) has an enhanced alternative drug benefit. This plan has a $0 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 $2000. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The CareSource MyCare Ohio (Medicare-Medicaid Plan) offers a wide variety of benefits, including coverage for inpatient and outpatient services, emergency services, and primary care with no copay. The plan also provides coverage for preventive services, hearing, vision, and dental services. The plan also includes coverage for medical equipment with no copay. Additional benefits include ambulance and transportation services, home health services, and dialysis services, all with no copay. The plan covers skilled nursing facility services with no copay. Other services, such as acupuncture and over-the-counter items, are also covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered, with additional days for both also covered. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Non-Medicare-covered stay 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, but requires prior authorization. There is no information about the cost of the service, so the copay and coinsurance are unknown.
Ambulance and Transportation Services See details
The CareSource MyCare Ohio (Medicare-Medicaid Plan) covers all ambulance services with no copay or coinsurance, but ground and air ambulance services are not covered. Transportation Services to plan-approved health-related locations are covered for up to 60 one-way trips per year, and there is no copay or coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CareSource MyCare Ohio (Medicare-Medicaid Plan), with no copay or coinsurance for Emergency Services and Urgently Needed Services. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services, with no copay or coinsurance for Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services. Chiropractic Services, Mental Health Specialty Services, and Psychiatric Services are partially covered, and Podiatry Services are not covered. Additional Telehealth Benefits are available for some services.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and other preventive services, are covered by CareSource MyCare Ohio (Medicare-Medicaid Plan). However, health education, in-home safety assessments, and other services are not covered.
Hearing Services See details
Hearing services are covered, including routine hearing exams and fitting/evaluation for hearing aids, with no copay. Prescription hearing aids (all types) are covered, with a limit of 2 visits, not more than once every 4 years for conventional and 5 years for digital or programmable; however, prescription hearing aids for the inner, outer, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for routine eye exams, eyewear, contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames; routine eye exams are available once per 12-month period for members under 21 and over 59, or once per 24-month period for members 21 through 59. 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. Oral exams are limited to 2 visits per year, dental x-rays are limited to 1 every six months, and fluoride treatments are limited to 1 every six months.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Insulin benefits, including Medicare Part B Insulin Drugs, are covered.
Dialysis Services See details
Dialysis Services are covered with no copay and no coinsurance.
Medical Equipment See details
Medical Equipment is covered under the CareSource MyCare Ohio plan, including Durable Medical Equipment, but excluding Durable Medical Equipment for use outside the home. The plan has no copay or coinsurance for Durable Medical Equipment, and some non-Medicare-covered Durable Medical Equipment is covered. 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 not covered under the CareSource MyCare Ohio (Medicare-Medicaid Plan). The plan does not cover Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, or Outpatient X-Ray Services.
Home Health Services See details
Home Health Services are covered by the CareSource MyCare Ohio (Medicare-Medicaid Plan) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the CareSource MyCare Ohio (Medicare-Medicaid Plan), including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, including additional days beyond Medicare-covered and non-Medicare-covered stays. Prior authorization is required, and there is no copay for SNF services.
Other Services See details
Other Services include acupuncture, over-the-counter items, meal benefits, and additional services, with varying coverage details. Acupuncture is covered with prior authorization, and over-the-counter items are covered up to $100 every three months, with a carryover of unused amounts.
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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Every year, Medicare evaluates plans based on a 5-star rating system.
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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We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
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