You may received extra "value-added" services from your health plan beyond what is available to you under Medicaid. Some examples of value-added services are adult dental services and diapers for newborns. Adults receive one physical exam per year, not covered in regular Medicaid. Children (under 21 years of age) received regular check-ups medical exams and dental services through Texas Health Steps.

You MAY enroll in the STAR program or choose to say in regular Medicaid if you are receiving Supplemental Security Income (SSI) (NOTE: Persons receiving SSI and living in the Southeast Region cannot enroll in the STAR program.)

The first way is through a Health Maintenance Organization (HMO), which is an organization that provides health services to its members also called a health plan. You will become a member of an HMO, carry a health plan ID card, and get a member handbook. You will choose a doctor, called your Primary Care Provider (PCP). You will use only providers in the HMO group of providers called a "Network.

The State of Texas has selected certain counties to have a Medicaid managed care program called STAR (which stands for State of Texas Access Reform.) The STAR program offers Medicaid services to members, except in a different way, called managed care. You will have to choose a health plan. You choose a doctor, called a Primary Care Provider (PCP) who works with you to keep you healthy and gets you to other doctors, services, and specialists. The PCP is your medical home.

If you live in one of the following areas, you may be eligible to enroll in the STAR Medicaid Managed Care Program:

The recipient can enroll in one of three ways: 1) over the phone by calling MAXIMUS, the enrollment broker; 2) through the mail, by submitting an enrollment form (available from MAXIMUS); or 3) in person, at any local Dept of Human Services office or Social Security office which has a MAXIMUS outreach counselor.

No, not until Special Needs Plans (SNPs) for persons with HIV infection are established. Currently, most managed care enrollment for persons on Medicaid in NYS is voluntary. However, with the approval of NYS's Partnership Plan by the Federal government, mandatory Medicaid managed care will be phased in over the next three years in NYS.

Medicaid clients in Texas urban areas will likely receive services through a Medicaid Health Maintenance Organization (HMO), often referred to as a health plan. Clients have a choice which health plan they use. Be sure to choose a health plan and primary care provider when you receive your enrollment packet. You can find more information about Medicaid managed care here .

You are an adult or a child with a serious mental illness who had at least ten mental health appointments or hospital stays in a year You are mentally retarded and get care from an intermediate care facility (or have health needs like a person in a facility) You are HIV+ or have AIDS, or have End Stage Renal Disease.

Maybe. Call New York Medicaid CHOICE at 1-800-505-5678 to quit Medicaid Managed Care. They will send you a form. You must sign and date the disenrollment form and send it back. You should get a confirmation letter. The letter will say that you are not in a Plan anymore. After 90 days, you must stay in your Plan for 9 more months before you can quit. But you can quit your Plan anytime if you have a good reason. Call New York Medicaid CHOICE at 1-800-505-5678 to quit.

There are 2 approaches to identifying Medicaid beneficiaries who were covered under a managed care plan. The Personal Summary File indicates if a beneficiary was in a managed care plan with coverage purchased by the state, and this information is indicated for each month. Primary Care Case Management plans are not included in the indicator since these services are paid fee for service.

In Regular Medicaid, you can go to any doctor, hospital or clinic that takes Medicaid. The doctor bills Medicaid, and Medicaid pays the bills Medicaid Managed Care is different from Regular Medicaid. In Medicaid Managed Care you join a plan that is in charge of your medical care. In Medicaid Managed Care there are many more rulesabout which doctors you can go to and how you get care. Here are some rules: You Get a Personal Doctor.

The provider application and instructions can be found on Iowa Medicaid Enterprise's (IME) web site. Any questions regarding the completion of the application can be directed to Iowa Medicaid Enterprise Provider Services 1-800-338-7909 or 515-725-1004 (from Des Moines).

Most offices are already utilizing an external financing company and have become accustomed to the program. The benefits of making the ALL Care Program your primary lending program are lower practices fees, above average approval rates and superior customer service. Practices that switch to ALL Care experience an average increase of 10% to their approval rate and save between 10-30% in practice fees.

Each state has some leeway in determining who is eligible for Medicaid; however, in order for the states to receive federal funds, there are certain groups that must be covered. For these people, Medicaid coverage is mandatory. They include recipients of aid to families with dependent children, or AFDC; infants born to Medicaid-eligible pregnant women; and children under age 6 and pregnant women with limited income.

People who cannot join a Managed Care Plan even if they would like to are called excluded. You are excluded and cannot join a Medicaid Managed Care Plan if: You live in a nursing home or a hospice, or a long term home health care program, state-operated psychiatric facility, or residential treatment facility for children

MetroPlus Medicaid Managed Care members must recertify once a year with New York City Human Resources Administration (HRA). HRA sends out a notice about 60 days before your recertification date with instructions on how to recertify. To find out more information on how to recertify click here. If you have not received a recertification packet please call the MetroPlus at 1-800-475-METRO and we will help you.

If you are already in a Medicare Advantage plan such as an HMO or local Preferred Provider Organization (PPO) that offers a drug benefit, you must use that plan's drug benefit or drop out of the Medicare Advantage plan if you want to enroll in another prescription drug plan. If you are not currently in a Medicare Advantage plan, you have a choice.

The 76th Legislature, House Bill 2896, placed a moratorium on the roll-out of Medicaid managed care. According to this legislation, the moratorium will expire at the end of current legislative session, if no further action is taken by the legislature. Any changes in roll-out status will be provided in updates to this question. This page maintained by the Texas Medicaid/CHIP Office. Comments and suggestions can be emailed to: contact@hhsc.state.tx.us.