10,000 face Medicaid sign-up

June 03, 1997


Staff Writer

An estimated 10,000 Washington County residents on Medicaid health insurance will need to sign up with one of four managed care organizations in the coming months.

According state regulations, those failing to meet the assigned deadline will forfeit the opportunity to choose from four programs, and instead will be assigned to one by the state health department.

Medicaid, federal health insurance for the poor, is changing in the state of Maryland. As of July 1, the state's HealthChoice program will be in full swing. It is a system of state approved managed care organizations designated and designed to provide care for Medicaid patients.


Not included are Medicaid recipients who also receive Medicare.

Beginning this week, recipients in Washington County will receive information on what they must do to sign up with one of four managed care organizations: Chesapeake FamilyFirst, FreeState Health Plan, Maryland Physicians Care and Priority Partners.

The sign-up information, provided by the Maryland Department of Health and Mental Hygiene, will include charts comparing the different services offered by the four groups. This includes which one provides dental coverage, transportation reimbursement and doctors fluent in languages such as Spanish.

It is critical for Medicaid recipients to pay attention to the information they get in the mail, said Dr. Robert Parker, director of the Washington County Health Department. He said selecting health care providers should be done by individuals, not the state.

The Maryland health department will move 330,000 Medicaid recipients into managed care groups in increments of 20 percent.

For the first week of each of the next five months, roughly 66,000 people will receive information packets and sign-up letters. This method will spread the administrative work over five months, with 100 percent enrollment reached by the end of October, officials said.

The first round of letters, sent early this week, will go to people receiving care from health maintenance organizations that are not a part of the HealthChoice program, such as Optimum Choice Inc.

Optimum will no longer be eligible for Medicaid reimbursements, and any Medicaid recipient receiving care from their doctors will need to switch over immediately, according to government documents.

The next mailing, to be the first week of July, will go to another 66,000 people randomly selected from across the state. Another round will go out the first weeks of August, September and October.

Once that information is received by Medicaid recipients, they will have 21 days to tell the department, either by phone or mail, which of the four managed care groups they wish to enroll with, the documents say.

Anyone who has failed to choose a program within that 21-day period will be assigned to one and informed at a later date about where they should start going for health care services.

Parker said some of the printed material will be out of date by the time later mailings go out. He said he'd like patients to call their doctors before enrolling with one of the groups to find out where and if their doctors have signed on.

The process will be confusing, Parker said. "We'll have to work out the bugs, but in the long run it will be much more effective," for taking care of low-income patients.

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