Managed Care

What is a Managed Care PlanĀ (MCP)?

A Managed Care Plan, or MCP, is like the services you get with the Medicaid card, with some important differences, and some important extra benefits. The MCP is responsible for paying for health care services for their members that they get through the doctors, hospitals, drug stores, and other health care providers that work with the MCP.

What do I have to do when I get a notice about choosing an MCP?

If you get a notice, read it carefully. It will tell you what to do. Once you get the notice, you can go to the Managed Care Enrollment Center web site for detailed information, or call them at 1-800-605-3040. They are open Monday through Friday, 8:00 am to 8:00 pm to answer your questions and help you make a choice about which MCP to join.

Who has to join an MCP?

Most adults and children who receive Healthy Start & Healthy Families Medicaid must join an MCP when they receive the notice. But, certain individuals may not be required to join an MCP. They are children under the age of 19 who are:

  • Receiving Supplemental Security Income or SSI.
  • Receiving federal foster care maintenance through an agreement between the local children services board and the foster care provider.

Managed Care Plans work with a variety of providers and healthcare organizations to establish supportive and meaningful relationships between providers and patients. MCPs also develop comprehensive treatment plans, and coordinate specialist care for patients. These services are provided in an environment that seeks to optimize health-related outcomes, promote the appropriate use of cost-effective medical care, and reduce unnecessary hospital stays and emergency room visits.

It is important to note that Aged, Blind, Disabled (ABD) members enrolled in an MCP will continue to receive all medically necessary healthcare services covered by their Ohio Medicaid card. However, MCPs often provide additional services that are particularly important to ABD consumers.

Some Managed Care services for ABD members include:

  • Access to a 24/7 medical advice line.
  • Care management services.
  • Access to relevant health information to manage their medical condition(s).
  • Transportation services.
  • Reduced or non-existent consumer co-payments/cost sharing.