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General Questions

For information on OhioRISE, including information on new and improved covered services:  

  • Visit managedcare.medicaid.ohio.gov/OhioRISE
  • Visit AetnaBetterHealth.com/OhioRISE.
  • Call OhioRISE Member Services at 1-833-711-0773 (TTY: 711) Monday through Friday from 7:00 a.m. to 8:00 p.m. 
  • Call the Medicaid Consumer Hotline at 1-800-324-8680 (TTY: 711) Monday through Friday from 7:00 a.m. to 8:00 p.m. and Saturday from 8:00 a.m. to 5:00 p.m.
  • Contact a care management entity (CME). Contact information can be located here

Ohio Medicaid managed care members will remain with their current managed care plan until Ohio Medicaid's Next Generation managed care plans begin providing healthcare coverage on December 1, 2022. 

  • Intensive and Moderate Care Coordination
  • Improved Intensive Home-Based Treatment (IHBT)
  • In-state Psychiatric Residential Treatment Facilities (PRTFs) – Available January 2023
  • Behavioral Health Respite
  • Primary Flex Funds
  • Mobile Response and Stabilization Services (MRSS) – Also covered by MCOs or FFS Medicaid

Children and youth who may be eligible for OhioRISE are:

  • Eligible for Ohio Medicaid (either managed care or fee-for-service),
  • Are age 0-20 at the time of enrollment, and
  • Require significant behavioral health treatment, measured using the Ohio Child and Adolescent Needs and Strengths (CANS) assessment.
  • Young people may also be eligible for OhioRISE due to certain urgent conditions. For example, if a child or youth is  in a hospital for behavioral health reasons.

In early 2019, Ohio Governor Mike DeWine called on Ohio Medicaid to ensure Ohioans get the best value in providing quality care.

In response, we conducted a series of listening sessions to hear from Ohio Medicaid members and providers across Ohio. We also gathered input through email, phone calls and mail. We received more than 1,000 comments including many suggestions for improving the current program.

Ohio Medicaid is “upgrading” our managed care program in order to address the issues we heard and meet the Governor’s and our goal.

This refers to the innovative changes Ohio Medicaid is making to upgrade the managed care program to align with our mission – to focus on the individual rather than the business of managed care. ODM wants to do better for the people it serves.

Ohio Medicaid encourages all managed care members to review and select the Next Generation plan that best fits their healthcare needs. Current Ohio Medicaid managed care members who do not select a plan will stay with their current plan, with the exception of Paramount members. 

Unless a current Paramount member chooses another plan, they will be enrolled with Anthem Blue Cross and Blue Shield during the implementation process. Members can review and select the Next Generation plan that best fits their healthcare needs at any time through open enrollment ending November 30, 2022. 

Medicaid Managed Care acts just like regular private health insurance for individuals enrolled in the Ohio Medicaid program.

In Ohio, most people approved for Medicaid are automatically enrolled for Medicaid Managed Care coverage. Shortly after enrolling in Medicaid, individuals get a letter asking them to choose a Medicaid Managed Care Plan (MCP). Once enrolled with a MCP, the plan sends a permanent card for use when seeking services from providers as well as information about the scope of coverage of the plan.

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