Ohio MyCare Laboratory Testing Policies
Ohio MyCare is a program designed for members in Ohio who receive both Medicaid and Medicare benefits. During enrollment, eligible members have two choices for how to receive their MyCare benefits: Either Dual-benefits or Medicaid-only benefits. The primary benefit of receiving Dual-benefits from one health plan is to have coordinated services with one point of contact.
Dual-benefits (also known as “Opt in”) are for members who have the same health plan that administers both their Medicaid and the Medicare benefits. CareSource Dual-Benefit members will follow CareSource laboratory testing policies using the following hierarchy:
Medicaid-only benefits (also known as “Opt out”) are for members who have one health plan administer their Medicaid benefits in conjunction with the traditional Medicare plan or private insurance company. CareSource Medicaid-only members will follow (links don’t need to be replaced) CareSource Ohio Medicaid policies.