Promise will continue care for all Medicaid patients after switch to MCOs

SIOUX CENTER � All Medicaid patients will be able to see their own provider and receive care at Promise Community Health Center in Sioux Center after Friday, April 1.

That�s the date when all Medicaid patients will be switched over to one of three Managed Care Organizations (MCOs): AmeriGroup, AmeriHealth Caritas or United Healthcare. These three companies are managing the care of Iowa Medicaid patients instead of the state � with the new program called IA Health Link.

Fatima Arteaga, community care coordinator for
Promise Community Health Center of Sioux Center,
assists a patient with paperwork. Promise's outreach
team can answer questions people have as Medicaid
transitions to a managed care system in Iowa.

The good news for Promise patients: The health center has agreements with all three of the MCO companies, so no matter which one they chose or were assigned to, they will have their health-care services covered at Promise. Not every health facility has such arrangements.

�We�re committed to continuing to care for them,� said Nancy Dykstra, executive director for Promise. �We�ll answer any questions that they have and keep them connected with their primary care provider.�

Jessica Mora and Fatima Arteaga of Promise�s outreach staff can assist anyone with any questions that they have regarding the transition to the managed-care system. People either can call Promise or walk in during open hours. The outreach assistance is free.

�You don�t have to be a patient of Promise to utilize our outreach services in getting your questions answered,� Dykstra said.

The new IA Health Link managed-care program will cover people who were under a variety of programs, including Medicaid, Healthy and Well Kids in Iowa (hawk-i), and Iowa Health and Wellness Plan.

Mora helped to answer some common questions Medicaid patients have been having:

Q: Do I bring in my new insurance card?

A: Yes. Mora said patients should start bringing in their new insurance card that they received in the mail from one of the new MCO companies for their next appointment starting Friday, April 1. That�s when their health-care coverage under the new system will begin.

Q: What if I haven�t received my card yet?

A: Most people should receive their new cards by Friday, April 1, but Mora said people are being advised to wait and be patient if they have not.

If patients have not received their card and come in for care at Promise, Mora said Promise�s outreach staff will help them work through that situation. They will call on the patient�s behalf to find out which MCO they will be covered under. They will call that company to find out when the card will be coming and to get instructions about how that appointment should be handled. Mora said they will do everything they can to help people navigate the system.

Jessica Mora, community care coordinator
for Promise Community Health Center's
outreach team, answers questions. She
can assist Medicaid patients who have
questions about their new coverage from
a Managed Care Organization (MCO).

Q: Will my benefits stay the same?

A: Yes. All the basic health-care services that were covered under Iowa�s Medicaid program are required to be covered by the MCOs.

Therefore, patients should not see their benefits change if their health-care provider has an agreement with the MCO on their insurance card.

Promise has arrangements with all three MCO companies, so all Promise patients can be assured that they will continue to receive full health-care coverage.

Q: Can I change my MCO?

A: Yes. All Medicaid patients either chose or were assigned  to an MCO insurance company for their health-care coverage prior to the April 1 transition; however, they do not have to stay with that company for the long term.

Mora said many patients didn�t know which company they should choose ahead of time, but she said they can take comfort in knowing that they can try one for awhile and then make a change if it is not a good fit for them.

People have until June 16 to change their MCO for any reason. After that date, they will be allowed to change their MCO for �good cause.� Examples of good cause include the patient�s provider not being in the MCO�s provider network, not all services being available in the MCO�s network or the patient�s eligibility changing.

Mora said Promise�s outreach staff is willing to assist people through the process of making a change in their MCO.

Q: What happens to new Medicaid enrollees?

A: Mora said the process for applying for Medicaid benefits will stay the same for new enrollees and isn�t expected to change in the foreseeable future. She said the same website will be used as in the past. If they are eligible for Medicaid, people then will select an MCO to receive coverage from.

Promise Community Health Center, headquartered in Sioux Center, is the only Federally Qualified Health Center in the far northwest corner of Iowa. Promise provides medical, dental, prenatal and behavioral health services. To learn more, visit www.promisechc.org.

WHO TO CONTACT:

Jessica Mora and Fatima Arteaga of Promise Community Health Center�s outreach team are available to answer any questions that people might have regarding the Medicaid shift to a managed-care system. They will help people work with the new Managed Care Organization (MCO) that they are covered by. Call Promise at 712-722-1700 or come in during Promise�s open hours to talk to them: 8 a.m.-7 a.m. Mondays and Thursday, 8 a.m.-6 p.m. Tuesdays and Wednesdays, and 8 a.m.-5 p.m. Fridays. The outreach assistance is provided at no charge.