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OhioRISE
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.
We use an approach called “wraparound” to build your child and family team (CFT). Your needs are at the center, and the team wraps around you to provide services, supports, education and resources.
Care coordinators and CMEs understand youth with behavioral health conditions involved with other systems — such as child protection, juvenile justice, and intellectual/developmental disabilities — and help connect them to the right care to meet their goals.
Get help
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. Gainwell Technologies covers all your other pharmacy services and benefits. They work with the Ohio Department of Medicaid to provide these benefits. Find contact information and learn more on our pharmacy page.
You can also find local resources and services.
Not sure if you qualify?
Not sure if you qualify?
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.
About us
About us
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.
You can go to the Aetna Better Health website to learn more.
Non-discrimination notice
Aetna Better Health® of Ohio follows state and federal civil rights laws that protect you from discrimination or unfair treatment.