Benefits Overview - West/Northeast
Buckeye Health Plan offers health insurance plans with comprehensive healthcare services that suit the needs of families and individuals throughout Ohio.
View some of Buckeye Health Plan's benefits below. The information on this page covers the West and Northeast regions of the state. To find out which service area you live in, see the Service Areas page. You can also view more information in our Member Handbook.
Buckeye provides round trip coverage for covered services 30+ miles away. In addition, Buckeye offers up to 15 round-trip visits (30 one-way trips) per member per 12- month period to covered healthcare/dental appointments, WIC appointments, and redetermination appointments with your CDJFS caseworker. Members can call directly 48 hours (two business days) in advance at 1-866-246-4358 (TDD/TTY: 1-800-750-0750) to schedule transportation. Members with questions or problems with transportation services may call Buckeye Member Services at 1-866-246-4358 (TDD/TTY: 1-800-750-0750).
You take care of your health; we offer a way to earn reward dollars when you complete certain healthy behaviors.
Earning and Using Rewards is Easy
- Complete a healthy activity.
- Reward dollars will be put on your CentAccout® Healthy Rewards Card after we receive the claim for your healthy activity.
- If it's your first reward, a card will be mailed to you.
- Spend your reward dollars at one of the following participating stores:
- Discount Drug Mart
- Dollar General
- Family Dollar
- Rite Aid Pharmacy
You can buy HUNDREDS of items with your card. Here are some of the items you can buy:
- Baby Care
- Personal Care
For a complete list of items you can buy, log in to your member account. Remember, this card is not a credit card. It already has funds on it. Keep the card after you use it. As you earn more rewards, they will be added to this card.
- For completing 6 infant well care visits by 15 months old (these visits are recommended before 30 days old and at 2, 4, 6, 9, 12, and 15 months old).
- For an annual well care visit (one per calendar year; age 12 and up).
- For getting your annual flu vaccine (one per flu season September - April; age 6 months to 5 years old and age 50 and up).
- For annual comprehensive diabetes care - must complete all of the following once in the calendar year:
- HbA1c Test
- Kidney Screening
- Retinopathy Screening
- For every 3rd prenatal doctor visit (up to 3 rewards total). *
- For a postpartum doctor visit (must be completed between 21 and 56 days after delivery).
* To be eligible for these rewards, you must notify us you are pregnant by submitting a completed Notification of Pregnancy (NOP) Form. Prenatal visit count begins after we are notified you are pregnant.
Already Earn a Reward and Receive a Card?
To activate your card, go to myotccard.com or call 1-888-682-2400. To check your balance, log in to your member account.
Care Coordination and Disease Management
Care coordination and disease coaching are part of your health benefits and are provided to you at no cost. Buckeye Health Plan pays for these services. We provide services for many conditions, such as asthma, diabetes, COPD, high-risk pregnancy and many more. Call Member Services at 1-866-246-4358 (TDD/TTY: 1-800-750-0750).
Cell Phone Program
Buckeye Health Plan is proud to be working with SafeLink Wireless to offer you this special, federal program. As a Member of our plan, you get all the same benefits of a SafeLink phone, plus unlimited inbound text messages and calls to Buckeye Health Plan member services. There is no added cost for these extras.
How to Enroll:
Choice of Doctor
As a Buckeye Health Plan Member, you can choose who you see for your healthcare needs from our network of Providers. We have many for you to choose from.
For the most part, you must get care from our network of healthcare providers. If you cannot get a covered service from one of our plan providers, we can allow the use of a non-plan provider for as long as needed. There will be no additional cost to you. Call us if you need help getting services.
Buckeye’s dental services include two periodic oral exams and cleanings per year (more than what is available with fee-for-service Medicaid).
Doctor Visits & Screenings
Preventative care visits are covered by Buckeye Health Plan. This means visiting the doctor for a regular check-up, rather than waiting until you are sick.
Buckeye Health Plan covers an annual physical for adults.
Regular child check-ups are also covered for those under the age of 21. These doctor visits should occur at the below ages. Children also need a blood lead test at 12 and 24 months of age. We cover this. After that, if they are high risk, they need the blood lead test each year age 3 to 6.
- Birth or neonatal exam
- 1 week
- 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 24 months
- 30 months
- After 30 months until age 21: one exam per year is recommended.
Keeping children healthy and growing the way they should is important. A big part of this is seeing the doctor regularly for Healthchek screenings—even when your child is not sick—in order to make sure your child stays healthy. Healthchek screenings help find problems or possible problems early, before they become serious. If a problem is found, Healthchek includes medically necessary follow-up care and referrals. Healthchek screenings are provided from birth to under 21 years of age. These services are covered as part of your Medicaid Care Coordination Plan.
For information on the HEALTHCHEK program please contact Buckeye Health Plan at 1-866-246-4358 (TDD/TTY: 1-800-750-0750) and ask to speak with the Quality Improvement Department or get in touch with your county’s Healthchek Coordinator by contacting your county department of job and family services.
Nurse Advice Line
Our Nurse Advice Line is ready to answer your health questions 24-hours-a-day – every day of the year. The Nurse Advice Line is staffed with Registered Nurses. These nurses have spent lots of time caring for people. Now they are ready and eager to help you. The services listed below are available by contacting Nurse Advice Line, Buckeye’s 24-hour nurse hotline, at 1-866-246-4358 (TDD/TTY: 1-800-750-0750).
We have a special program to connect you to quality healthcare and social services. It’s called MemberConnections™.
Our MemberConnections™ outreach representatives will talk to you on the phone when you call (866) 246-4358, send you information in the mail, and visit your home if you would like for them to come. They will be glad to talk to you about:
- How to choose a doctor
- How to change doctors
- Covered healthcare services
- How to use your healthcare services
- How to get medical advice when you can’t get your doctor
- Explain the difference in emergency and non-emergent care
- How to live a healthy life
- How to get immunizations and health screenings
- Any other healthcare service problem you may have
MemberConnections™ outreach representatives can also help connect you to community social services if you need food, housing, clothing, utility services, etc.
Pregnancy & Newborn Services
Start Smart for Your Baby (Start Smart) is our special program for women who are pregnant and for those moms who just had a baby. We want to help you take care of yourself and your baby every step of the way. If you are pregnant, please let us know by completing a Notification of Pregnancy form. After completing this form you will be enrolled in Start Smart. You will receive information in mail and over the phone. You can also get information in the Health & Wellness section.
Tips for Pregnancy
If you are pregnant or want to become pregnant, keep these things in mind:
- Go before you show! Go to the doctor as soon as you think you are pregnant. It is important for you and your baby to see a doctor as early as possible. It will keep both of you healthy. It will also help your baby get off to a good start. It is even better to see a doctor before you are pregnant. This is so you can get your body ready for pregnancy.
- Maintain healthy lifestyle habits. This includes exercising, eating balanced and healthy meals, and resting for 8-10 hours every night.
- Do not use tobacco, alcohol or drugs now or while you’re pregnant.
Doctors and health organizations agree that breastfeeding is best. You may already know that breast milk is packed with the perfect mix of nutrients your baby needs. Did you know that it is also more than just food? Breast milk has special ingredients, like antibodies, that only you can provide. Breast pumps are helpful if you are breastfeeding and have to be away from your baby. Call us after you deliver to see if breast pumps are offered.
Are You Pregnant? Tell Us Right Away!
Call us. Or, you can login to your Buckeye Health Plan account and fill out the Notification of Pregnancy form.
Other Languages & Format Needs
Interpreter services are provided free of charge to you during any service or grievance process. This includes American Sign Language and real-time oral interpretation.
If you need something translated into a language other than English, please call Buckeye Health Plan. We can also provide things in other formats such as Braille, CD or large print.
If you need an interpreter for your medical appointment, contact Buckeye Health Plan before your appointment. We will arrange for one to be at your appointment.
Buckeye provides annual eye exams for children AND adults. Eyeglasses are provided annually for children under the age of 21 and adults age 60 or older and every two years for adults age 21 through 59. We offer an expanded selection of eyeglass frames to choose from, a wider selection than what is available with fee-for-service Medicaid. Please check the provider directory for a list of doctors contracted with Buckeye.
Buckeye will provide $50 toward the purchase of contact lenses, per member per year (every two years for adults age 21 through 59), and $50 toward the contact lenses fitting fee your vision provider charges, per member per year (every two years for adults age 21 through 59). Contacts are not covered by fee-for-service Medicaid. Contacts and glasses may not be obtained in the same year (or in the same two years for adults age 21 through 59).