3rd-party Medicaid Re-enrollment Policies & Programs
The Department of Social Sciences in the state of Missouri contracts with third-party agencies to help Medicaid enrollees determine if they're eligible for Medicaid renewal. These third-party agencies include Home State Health, WellCare, and United Health Care. Below is our methodology and a deep dive into our findings.
In order to determine if third-party agencies in the state of Missouri can help Medicaid enrolees determine if they are eligible for Medicaid renewal, we started our search through various websites belonging to a number of departments in the State of Missouri including the Missouri Department of Social Sciences. We hoped to find rules, policies, and guidelines about the eligibility for Medicaid application and renewal. We found several articles that outlined the Medicaid application and renewal procedures. However, the sources did not provide the role of third-party private agencies in helping Medicaid enrolees determine their eligibility for Medicaid renewal.
Next, we reviewed the guidelines surrounding the MO HealthNet Managed Care Program. This is a Medicaid program in the Missouri Department of Social Services. From this website, we established that indeed third-party agencies are used to offer information to Medicaid members about eligibility for application and renewal. We also established the examples of the third-party organizations that have partnered with MO HealthNet Division for these services. Finally, we visited the various companies' websites to get more details about the services they offer which we have detailed below.
state of missouri and third-party agencies
The State of Missouri Department of Social Services through the MO HealthNet Division (MHD) contracts with Managed Care Organizations (MCOs) to provide Medicaid enrolees with the necessary health care services. Services offered by MCOs include ambulance, family planning services, home health services, and inpatient and outpatient services among others. These MCOs also provide information on the eligibility for Medicaid renewal. Examples of Managed Care Organizations include Home State Health, WellCare, and United Health Care.
WellCare specializes in government-sponsored health care in the following major areas: Medicaid, Medicare Advantage, and Medicare Prescription Drug Plans. In Missouri, these services are offered by WellCare's subsidiary, Missouri Care. Missouri Care offers all coverage information about eligibility for Medicaid enrollment and renewal. It also provides coverage for all MO HealthNet health programs including MO HealthNet for Kids, MO HealthNet for Pregnant Women, and MO HealthNet for Families.
HOME STATE HEALTH
Home State Health (Home State) is another private organization in Missouri that helps Medicaid enrolees determine their eligibility for Medicaid renewal. It is contracted under the MO HealthNet Managed Care program and works with physicians, specialists, hospitals, and other providers to ensure each member receives the right care. The company updates existing and prospective members with information on Medicaid eligibility, benefits and other relevant information. Home State's website also has a New Members ToolKit section which contains information on Medicaid eligibility and the application process for new members.
United Healthcare is also another Managed Care Organization that is contracted by the Department of Social Services' MO HealthNet Division (MHD) in Missouri to provide healthcare services to Medicaid enrolees. It offers various health insurance plans and has a contract with the State Medicaid Program. The company also offers information about Medicaid eligibility, application, and renewal to new and existing members.