| TO: | ALL COUNTY OFFICES |
| FROM: | JANEL R. LUCK, DIRECTOR |
| SUBJECT: | MANAGED CARE EXPANSION |
DISCUSSION:
Income Maintenance Memorandums IM-97 dated September 21, 2007, and IM-2 dated January 7, 2008, discuss the expansion of managed care in 17 counties. Open enrollment ran through January 17, 2008, for all individuals except those in State care and custody. Individuals not choosing a MO HealthNet Managed Care health plan prior to January 17, 2008, were auto-assigned to a MO HealthNet Managed Care health plan on that date. Individuals in State care and custody have 90 days to choose a MO HealthNet Managed Care health plan. Individuals in State care and custody that do not make a choice within the 90-day period will be auto-assigned to a MO HealthNet Managed Care health plan at the end of the 90-day period. The MO HealthNet Managed Care health plan will send the new member a MO HealthNet Managed Care health plan identification card and handbook containing information about MO HealthNet Managed Care health plan benefits.
The participant will be Fee-For-Service until they are enrolled in a MO HealthNet Managed Care health plan either by choice or by assignment. Once enrolled in a Managed Care health plan, enrollees have a 90-day change period to transfer to a different Managed Care health plan for any reason. Once the 90-day change period ends, the enrollee is locked into the Managed Care health plan for one year. Children in State care and custody are allowed automatic and unlimited changes in MO HealthNet Managed Care health plan choice as often as circumstances necessitate.
Participants who express difficulties with receiving services through the MO HealthNet Managed Care health plan should be referred to the Member Services Department at the applicable health plan. Even though the health plan may periodically close due to the weather, they are required to have their Member Services Departments staffed 24 hours per day, 7 days per week. The phone number for the applicable health plans may be found at: www.dss.mo.gov/mhd/mc/pages/healthplan.htm.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.