Maryland Managed Care Plan

Overview:

Assume you are a Maryland resident and Medicaid recipient looking to enroll in a managed care plan, review the Maryland Managed Care Website(s) at: https://mmcp.health.maryland.gov/healthchoice/Pages/HealthChoice-Enrollment.aspx

https://mmcp.health.maryland.gov/healthchoice/pages/home.aspx

Assess and evaluate HealthChoice, Maryland’s statewide mandatory managed care program based on the following evaluation criteria. Please choose one (1) of the MCO’s under HealthChoice to evaluate (e.g., Maryland Physician’s Care).

Using the table format below, answer the questions (using a narrative format) in each section that appear in bold type. Please be sure to include a reference page.

HGMT 420 Assignment #5

Student Name:

Type your name here

Assignment #5 Title

HealthChoice/Maryland Managed Care Plan

Benefits Offered and Services Covered

You want a plan that offers a comprehensive benefits package including preventive care as well as treatment programs for chronic disease management. Also, you may need emergency care and/or care away from home. What questions would you ask to determine the benefits and covered services offered? Evaluate the HealthChoice plan and summarize your findings.

Cost vs. Benefits

Managed care plans vary widely in the cost of services offered. It may be tempting to base your selection primarily on the periodic, out-of-pocket costs to you. You can’t be sure that the least expensive plan will give you all the medical services you need. Review cost vs. benefits for the HealthChoice plan carefully and summarize your findings.

Services of the Primary Care Physician

Choosing your primary care physician (PCP) may be the most important decision you make when enrolling in a managed care plan. The following questions are important when choosing your plan: Please answer each question.

· Can you choose more than one PCP for your family?

· Is there a large choice of primary care doctors and specialists?

· How long is the average wait to get an appointment with the chosen PCP?