Instead of the state paying providers directly for each service, the MCOs receive a fixed monthly payment per enrollee. Understanding the Kentucky Medicaid System The Kentucky Medicaid program is a joint federal and state initiative designed to provide health coverage to eligible low-income individuals and families.
Kentucky Medicaid Managed Care Provider Directory
How It Works for Members Enrollment: Eligible individuals are automatically or actively enrolled in an MCO that serves their geographic area. Specialist Access: Referrals to specialists are typically handled by the MCO, streamlining the process for the member.
What is Medicaid Managed Care? Medicaid managed care is a system where the state contracts with private insurance companies, known as managed care organizations (MCOs), to deliver Medicaid benefits. The state has engaged several regional and national MCOs to serve different zones, ensuring geographic diversity and competition.
Kentucky Medicaid Managed Care Provider Directory
For many residents, especially those with low incomes, the system known as Medicaid managed care represents the primary pathway to accessing essential medical services. This includes preventative care, emergency services, hospitalization, prescription drugs, mental health services, and long-term care.
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