Which Medicaid Plan Pays More?

Sep 18, 2023

When considering Medicaid credentialing, the plan(s) in which you enroll depends solely on your patient demographics.

One question we commonly get:

Which Managed Care Plan Pays More?

Regardless of the Managed Care Plan you choose, the covered dental Medicaid services are reimbursed at the same rate.

So, choose your Managed Care Plan(s) based on your patients' profile:

Pediatric-focused providers should enroll with MO HealthNet and then one or all of the Managed Care plans, as your Medicaid-eligible patients are most likely covered under one of the Managed Care Plans.

Adult-focused providers, should enroll with MO HeathNet, as your Medicaid-eligible patients are most likely covered by MO HealthNet and considered Fee-For-Service.

Here's a reminder on the differences between Fee-For-Service and Managed Care: 

Managed Care (MC): In 2017, children, pregnant women, newborns and families were
transitioned to the state’s three MC health plans (United HealthCare, Home State Health and
HealthyBlue). The MC health plans are responsible for administering benefits and coverage on
behalf of MO HealthNet to these populations. Note: A sub plan administered by Home State
Health is Show Me Healthy Kids, specifically for instances of state custody, adoption subsidies
and foster care.

Fee-For-Service (FFS): The aged, blind, disabled and women with breast or cervical cancer
remained in FFS. Providers will work with MO HealthNet directly when providing dental services
to these individuals

Still Unsure Which Plans with Which to Enroll?
Check out Verifying Patient Eligibility to help you determine with Managed Care Plan(s) may be right for you. 

Need More?
Your Medicaid Mentor – Jessica Emmerich, is here to offer you support. Email, call, or text her at 573-536-2474.