Medicaid Managed Care

Medicaid Managed Care

Updated May 2016

Step 2, Phase I is now complete.  As of February 1, 2016, the following individuals are also in 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 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) including Choices for Independence (CFI) Services, Nursing Facility Services, Developmental Disability (DD), Acquired Brain Disorder (ABD), and In-Home Support (HIS) services.

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June 18, 2014 News from Governor Hassan: letter outlines implementation plans for Step 2 of the NH transition to managed care.

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 currently contracts with two MCOs  to provide health care coverage for most New Hampshire Medicaid recipients. 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.

Link to the NH DHHS website for the NH Medicaid Managed Care program

The managed care health plans are:

Resources:

The Law:

Policy information:

News & Opinion Columns: