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Frequently Asked Questions

Is there such a thing as a Medicaid HMO?

Medicaid HMOs exist in almost every state. These plans are still considered Medicaid, but they are separate from traditional Medicaid. You will need to undertake payer enrollment in traditional Medicaid first before you can enroll in any Medicaid HMOs in your state offers.

How do I enroll in a Medicaid HMO plan?

Enrolling Medicaid HMO Plans. Medicaid HMOs exist in almost every state. These plans are still considered Medicaid, but they are separate from traditional Medicaid. You will need to undertake payer enrollment in traditional Medicaid first before you can enroll in any Medicaid HMOs in your state offers.

What happens if you are not enrolled in a Medicaid HMO?

Enrolling in Medicaid and Medicaid Managed Care Plans (HMO) All others are generally rolled over to a Managed Care Plan, which means they must select a Medicaid HMO and a PCP. If you see one of these patients and you are not enrolled in their HMO and selected as their PCP, you will not be reimbursed for your services.

What are Medicaid managed care plans (MCOs)?

Medicaid Managed Care Plans provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.