PM 20-24-01: Enrolling in an MCO

WAG 20-24-01.

MCOs provide information about their programs directly to clients. HFS does not refer clients to MCOs. MCOs provide the central office with the information needed to enroll clients in managed care. No Family Community Resource Center action is needed.

Enrollment in an MCO is effective 20 to 75 days after the processing of the enrollment form by the central office.

When an MCO member who is the caretaker relative gives birth and the newborn is added to the case before the newborn is 45 days old, MCO coverage for the newborn is retroactive to the date of birth. MCO coverage for all other newborns is prospective.

Eligible enrollees under age 19 added to a case in which all other members are enrolled with the same MCO are also enrolled with the MCO prospectively.