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What Is Virginia Medicaid Managed Care?

Enrolling in Virginia Medicaid Managed Care

Changing Health Plans or Doctors

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Enrolling in Virginia Medicaid Managed Care

Enrolling is easy. To enroll, choose an MCO or a MEDALLION PCP. You will get a letter saying what you can choose.

Who can enroll

Most people in Medicaid must enroll in managed care. People with other insurance, in foster care, or in a nursing home may not be asked to enroll.

How to enroll

Your Medicaid letter will give the name of an MCO or a MEDALLION PCP for you. (If you are in Medicaid and want to enroll, but you did not get a letter, call the HelpLine at 1-800-643-2273).

To choose the MCO or MEDALLION PCP in your letter, you don't need to do anything to enroll.

To choose a different MCO or MEDALLION PCP:

• Read about choosing (below), and call the HelpLine if you have questions. Call 1-800-643-2273.
• Make your choice.
• Call the HelpLine to tell us your choice. Call 1-800-643-2273.

Your new MCO will send you a letter telling you when you can start using services.

You can change your MCO or your MEDALLION PCP within 90 days after you enroll. You can change your MCO or MEDALLION PCP each year during open enrollment.

Choosing an MCO or MEDALLION PCP

Choose the MCO or MEDALLION PCP that is best for you or your family.

1. Read the MCO Comparison Chart or PCP listing that came with your letter, or read a comparison chart online. (Charts will open in a new window.) See which hospitals work with each MCO, and see what extra services each MCO has.
2. If you have a doctor now, find out what managed care plans your doctor works with.
3. Call the Medicaid Managed Care HelpLine, 1-800-643-2273. HelpLine staff can answer your questions and help you decide which managed care plan is best for you.
4. When you are ready to choose, call the Medicaid Managed Care Helpline to tell us your choice. Call 1-800-643-2273.

Compare the MCOs in your city or county

Most cities and counties in Virginia have 3 or 4 MCOs. You can see a chart that compares MCOs in your area and shows hospitals, extra benefits and extra services of each MCO.

To see a chart of health plans near you, click on your city or county, below.

Some areas do not have MCOs: Some areas have the MEDALLION program instead of MCOs. People in those areas are in the MEDALLION program and choose a PCP but not an MCO. If you click on a MEDALLION city or county, you will see a brochure about choosing a PCP.