By Sarah Cooley
I’m trying to prepare a journey
Wanting to see what will
Happen to me in this world
A new year is coming
And I feel scared by it
Updated November 5, 2015
Updated November 5, 2015
Step 2, Phase I is now underway. Open enrollment for those individuals who were previously able to opt out of managed care began on November 1st. Individuals in the following groups must now “opt in” to managed care: Children in Foster Care, Medicare Dual Eligibles (people who have both Medicare and Medicaid), Home Care for Children with Severe Disabilities (aka Katie Beckett Medicaid), Children with special health care needs enrolled in Special Medical Services/Partners in Health, and Children with Supplemental Security Income. If you fall into one of these categories, you will have until December 31st to choose one of the two managed care organizations. If you do not choose, the DHHS will automatically assign you to one of the MCOs. Services under the MCOs will begin on February 1st, 2016. If you have been automatically assigned to a MCO, you will have until May 1, 2016 (90 days) to select a different MCO if you so choose.
If your child has access to Medicaid services through the Katie Beckett program and the State contributes any amount towards the premiums of your private insurance, you will not have to go into managed care, but can remain on fee-for-service.
No date has yet been set for future phases of Step 2 moving into managed care which includes those receiving Long Term Supports and Services (LTSS) such as Choices for Independence (CFI) Services; Nursing Facility Services; and Developmental Disability (DD), Acquired Brain Disorder (ABD), and In-Home Support (HIS).
What is Medicaid Managed Care?
In a Medicaid managed care system, Medicaid recipients are provided health care coverage from a company under contract with the state. Managed care companies, or MCOs agree to provide Medicaid benefits to recipients in exchange for a monthly payment from the state. The State of New Hampshire origiinally contracted with three MCOs to provide health care coverage for most New Hampshire Medicaid recipients; one (Meridian) has withdrawn as a provider. The remaining companies are: NH Healthy Families and Well Sense Health Plan.
Problems with Managed care? Read this:
KNOW YOUR RIGHTS New Hampshire Medicaid Managed Care Health Plans: Your Right To Appeal Or File A Grievance, or call Disability Rights Center - NH at 1-800-834-1721 for more information about the grievance and appeal processes or for advice and/or representation in a Medicaid fair hearing.
You have the right to voice any concerns to New Hampshire Medicaid at any time. You may contact New Hampshire Medicaid Client Services by phone at 800-852-3345, ext 4344 or 603-271-4344.
You may also contact these individuals:
The managed care health plans are:
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