Do I Have to Enroll with All the Managed Care Plans?

Oct 15, 2023

Providers who plan on seeing children, pregnant women, or individuals eligible for family Medicaid will need to enroll with the MO HealthNet Managed Care Plans.

And providers often ask us this:

Do I Have to Enroll in Every Plan?

Providers are encouraged to enroll in all three plans but, it’s not required.

At minimum, providers must be enrolled with the same plan as their patient to provide eligible services. And most patients have the option to choose their Managed Care Plan.

Each Managed Care plan covers the same services as MO HealthNet and reimburses at the mandated rates.

Additionally, providers have the option to negotiate their rates with the Managed Care plans through the contract process.

Here Are Your Managed Care Plan Options:

Missouri Healthy Blue (DentaQuest)

Learn More

Home State Health (Envolve)

Learn More

United HealthCare

Learn More

The Managed Care application process could take 45-60 days.

All providers are required to enroll with Missouri Medicaid Audit and Compliance (MMAC) before enrolling with any of the Managed Care plans.

Ready to Get Started with Medicaid Credentialing?
Check out Credentialing Checklist to help complete your application. 

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