What is HealthChoice?
HealthChoice is Maryland's Medicaid managed care program. Most people who qualify for Medicaid are required to enroll in a Managed Care Organization (MCO).
It is best to select an MCO that your doctor particpates with. If your doctor does not participate in the MCO you select or are assigned to, you will need to choose another primary care doctor (PCP) to oversee your medical care.
What is HealthChoice MCO?
An MCO is a group of doctors, clinics, and other health care providers who work together to take care of HealthChoice members' health care needs.
MCOs are responsible for providing or arranging for most of your health care services including most pharmacy services. Some services, such as mental health and substance use disorder services, and certain drugs are coverd by the State and not your MCO.
The Administrative Care Coordination Unit serves as a local resource for all HealthChoice members. The ACCU can:
- Help you understand your Health Choice benefits and how to access services.
- Explain your MCO choices.
- Help you find a primary care doctor or specialist in your MCO's network. (You can change PCPs at any time.)
- Help you find a dentist. (MCOs are not required to cover dental services for adults.)
- Help link you to Medicaid transportation services. (MCOs are not required to provide transportation.)
- Help to get your prescriptions filled.
- Explain your annual right to change MCOs.
More examples of help that is only a phone call away:
- Explanation fo how to renew your Medicaid benefits through the Maryland Health Connection.
- Instruction on how to keep your information updated and how to get a new Medicaid card if your card is lost or stolen.
- Help resolving billing issues.
- Explanation of your appeal and grievance rights.
The local Ombudsman acts as an advocate for your health care needs.
An Obmudsman may contact you when there are complex medical issues involving care doordination with the MCO.
The HealthChoice Program may also request that an Ombudsman contact you to ensure that any complaints that you have about your health care or MCO have been resolved.
Monday - Friday
8:00 a.m. - 5:00 p.m.