Ohio Medicaid Healthplan Experience Comparisons

Hello r/medicaid 👋🏽

Longtime lurker, first time poster. It's open enrollment in Ohio and I was wondering if there are any other Ohioans here that could provide pros and cons of the companies they go through.

I have medicaid through Caresource and have also had it through Buckeye years ago.

There is also a comparison breakdown at this link: https://ohfiles.blob.core.windows.net/public/OhioMHWebsite/Documents/OhioMyCareComparisonChart.pdf

But I am more looking for others’ actual experiences, since we know what’s documented and “supposed” to be covered may or may not be what is actually covered.

I'm particularly interested to see what people have had trouble getting covered, if you could share why you think you had trouble, and what you suggest or who you would change to going forward.

*Edited formatting so someone can hopefully see and give input 😭

Caresource

Pros:
Recognized by many
Nurse hotline
ER doctor hotline: successfully got antibiotics through an ER Doctor video call
Used with Trihealth, Cleveland Clinic, Kettering Health, and Mercy
Kroger Little Clinic visits and labs covered
All of my medications are covered
They used to give you a little gift card or cash card if you went to get a yearly wellness check from your PCP of choice
Covered emergency surgery
Covered preventative surgery
Covered all of my urgent care visits

Cons:
Very difficult to find psychiatrists and psychologists that are fully covered without needed referral (I have yet to find any)
Very difficult to find dental health providers that are covered (had success, was very unpleasant and weird but it was covered, still looking for better (less painful) provider)
Some hospital networks don’t accept it, only doctor by doctor within a practice or hospital
Didn’t pay for labs from Seven Hills Women’s Centers a few years ago
Really bad provider database structure for patients to look up who they can go to. I’ve called some places to be told the provider stopped practicing more than 2 years ago
Really bad user interface on their website and many links just turn into link circles to a home page.

Buckeye
Pros:
Nurse hotline
Covered medications when I was on it
They used to give you a little gift card or cash card if you went to get a yearly wellness check from your PCP of choice

Cons:
No one believed they were a real provider!
Very few providers actually accepted them, despite there being a lot of providers listed on Buckeye’s website
Didn’t cover labs for typical preventative checks
Only partially covered BCP when I was on it