Changes in Medicaid-What it means for you! - Access Health Louisiana

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Changes in Medicaid-What it means for you!

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If you’re one of the nearly two million Louisiana residents covered by Medicaid, changes are ahead.  Currently, Louisiana’s Department of Health and Hospitals (LDHH) has contracts with five Managed Care Organizations (MCOs) tasked with overseeing the healthcare of its Medicaid patients.  With contracts expiring at the end of 2019, MCOs have spent the past six months bidding for either renewal or acceptance.  In August, LDHH announced its intent to award just four Medicaid contracts instead of five.

Long story short – Humana Health Benefit Plan of Louisiana, United Healthcare, Community Care Plan of Louisiana (Healthy Blue) and AmeriHealth Caritas Louisiana are in.  Louisiana Healthcare Connections and Aetna are out.  Plans not awarded a contract can file an appeal.

So, what does this mean if you’re a Medicaid patient covered by Louisiana Healthcare Connections or Aetna?  The good news is that the award of these new contracts will not affect your Medicaid eligibility.  However, you may need to choose a new health plan if your current health plan was not awarded a new Medicaid contract.

“I think it is important for patients to remember during this transition period that while their insurance plan may be changing, their primary care provider does not,” explains Chatrian Kanger, Vice President of Population Health for Access Health Louisiana.  “Patients of community health centers throughout the state – like at Access Health Louisiana – can rest assured that we can and will continue to take care of you regardless of what your insurance card says.  We can even take care of you if (for some reason) you experience a lapse in coverage.”

You will have the opportunity to select a new managed care plan through the open enrollment process starting in October.  You may also receive a letter in the mail from your current health plan telling you about the changes.  If you are currently covered by Louisiana Healthcare Connections or Aetna, Medicaid will provide assistance and information to you through the state Medicaid website, Medicaid providers, as well as the mail.

Kanger offers this advice for patients who could be impacted by these contract changes.  “First, we are advising all of our patients to take advantage of open enrollment to select the best plan for you and your family.  Next, make sure that your address and phone number are up to date with your Primary Care Provider (PCP) and the Medicaid website.  Pay attention to start and end dates and effective dates that will affect your coverage.  Finally, now more than ever, it will be important to ensure that you take advantage of your benefits for wellness visits with your PCP to ensure that your own care needs are met without gaps throughout the transition.”

All of the managed care plans selected by the state offer incentives to patients for fulfilling different health measures, such as getting their annual physicals.  Incentives vary by plan so be sure to do your research before deciding on which plan to go with in October.

Most physicians and Nurse Practitioners are credentialed with all Medicaid MCOs so you if you like your provider, you don’t have to give up great service.  “The state’s new methodology for patient/provider assignment effective July 1st this year ensures that your assigned Primary Care Provider will be based upon your claims history in this most recent year,” states Kanger.  “So, continue seeing your regular primary care or family practice provider and the details [behind insurance companies] will take care of themselves!”

Open enrollment is currently scheduled to begin October 15th and runs through November 30th.  If you are currently uninsured, consider applying for expanded Medicaid.  You can apply at any Access Health Louisiana community health center or call toll-free 1-866-530-6111 to schedule an appointment today.