Medicaid Open Enrollment is in August

Open Enrollment beings August 1st for Granite Staters who are in Medicaid Care Management. There are now three MCOs to choose from: NH Healthy Families, Well Sense Health Plan and AmeriHealth Caritas NH. Click here for open enrollment materials.

Enrollees who want to remain with their current health plan don’t have to do anything. Enrollees who want to change must do so by August 30th. Their coverage date will begin on September 1.

Because of the State’s new MCO contracts, enrollees will have an additional 90 days (September 1 – November 29) to change health plans one time. Coverage will begin on the first day of the month that follows their switch date.

It will be important for providers to diligently check Medicaid client eligibility between September 1st and December 1st and beyond. Enrollees are allowed to continue to receive services and prescriptions that had been approved by their prior plan for up to 90 days, or until their new plan reviews and approves their treatment. Providers should be prepared to request prior auths from an enrollee’s new health plan within that 90 window. This open enrollment applies only to those Medicaid enrollees who receive state plan services through an MCO. This does not apply to Choices for Independence services, which are covered directly by the State of NH. For questions, contact the Medicaid Service Center at 1-888-901-4999.