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How OhioRISE works

OhioRISE benefits start with a system of care that focuses on youth and families. We cover specialized behavioral health services to meet your unique needs. Care coordinators and care management entities (CME) partner with you to create a team and support you every step of the way.

Obtenga ayuda

Just contact us for questions.

 

You can call 1-833-711-0773 (TTY: 711). We're here for you 7 a.m. to 8 p.m. Eastern Time, Monday through Friday.

 

Questions about your other Medicaid health benefits? Contact your Medicaid managed care organization (MCO) for other health benefits, like physical health or rides to doctor visits.

 

If you are not a member of an MCO, contact the Ohio Medicaid Consumer Hotline for information on your other health benefits. Just call 1-800-324-8680. You can get help Monday through Friday, 7 a.m. to 8  p.m. and Saturday, 8 a.m. to 5 p.m.

OhioRISE covers medications your doctor gives you in the office to treat mental health and substance use disorders. If you are a member of a managed care organization (MCO), all other pharmacy services and benefits are provided through your MCO.  Find contact information and learn more on our pharmacy page.

 

If you are not a member of an MCO, contact the Ohio Medicaid Consumer Hotline regarding your pharmacy benefits. Just call 1-800-324-8680, Monday through Friday, 7 a.m. to 8 p.m. and Saturday, 8 a.m. to 5 p.m.

 

You can also find local resources and services.

¿No está seguro de si reúne los requisitos?

¿No está seguro de si reúne los requisitos?

Youth who may qualify for OhioRISE meet these requirements:

 

  • Are under age 21
  • Be determined eligible for Ohio Medicaid 
  • Not be enrolled in a MyCare Ohio plan, and have one of the following:

     

    • Certain needs for behavioral health care, identified by the Ohio Children's Initiative (OCI) and the Child and Adolescent Needs and Strengths (CANS) assessment, or
    • Have a recent inpatient hospital stay for mental illness or substance use disorder, or 
    • Have a recent inpatient stay in a Psychiatric Treatment Facility (PRTF).

 

Youth who may qualify for the OhioRISE 1915(c) waiver meet these requirements:

 

  • Are under age 21
  • Be determined eligible for Ohio Medicaid 
  • Not be enrolled in a MyCare Ohio plan 
  • Be determined to meet the following level of care (LOC) criteria for inpatient psychiatric (IP) services
    • Have certain needs for behavioral health care, identified by the Ohio Children's Initiative (OCI) and the Child and Adolescent Needs and Strengths (CANS) assessment, 
    • Have a diagnosis of serious emotional disturbance (SED), and 
    • Have documented functional impairment and behaviors.

 

If you’re enrolled in a MyCare Ohio plan and have qualifying needs for OhioRISE services, you can still get access to the care you need. Please contact the Medicaid Consumer Hotline if you’d to talk about your options. Just call 1-800-324-8680 (TTY: 711), Monday through Friday, 7 a.m. to 8 p.m. and Saturday, 8 a.m. to 5 p.m.

 

Learn more about qualifying

Conózcanos

Conózcanos

OhioRISE is a Medicaid managed care program that offers specialized behavioral healthcare for youth from Aetna Better Health of Ohio, part of Aetna® and the CVS Health® family. We’ve been serving people with Medicaid benefits for over 30 years. So, we have the expertise and experience to help children and youth with complex behavioral health and multi-system needs.

 

Our national experience helps us do a lot of great work in your community, where you live, work and play. We’re proud to be your neighbor, working alongside you to make Ohio a great state. Your family can get the care they need to be as healthy as possible. And, they can do it all close to home.

 

Visite el sitio web de Aetna Better Health para informarse más.

Non-discrimination notice

 

Aetna Better Health® of Ohio follows state and federal civil rights laws that protect you from discrimination or unfair treatment.

 

Read our full non-discrimination notice