Managed Care Organization List by State in the US

In the United States, there are numerous Managed Care Organizations (MCOs) that provide healthcare services to millions of people. These organizations operate in every state, each with its own unique characteristics and offerings.

Alabama has a relatively small number of MCOs, with UnitedHealthcare and Aetna being two of the largest providers.

Arkansas has a mix of for-profit and non-profit MCOs, with Arkansas Blue Cross and Blue Shield being a prominent player.

California has the largest number of MCOs in the country, with Kaiser Permanente being one of the most well-known providers.

Florida has a high concentration of MCOs, with Humana and UnitedHealthcare being two of the largest providers.

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Medicaid MCO Enrollment Data provides a wealth of information about the number of people enrolled in Medicaid managed care organizations (MCOs).

The data shows that Medicaid MCOs are a significant part of the Medicaid program, with multiple MCOs operating in each state.

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You can view details about the total number of Medicaid MCOs, as well as the total Medicaid MCO enrollment, by clicking on the corresponding links.

The share of the Medicaid population covered under different delivery systems is also an important metric, showing how many people are enrolled in MCOs versus other types of Medicaid plans.

Here is a breakdown of the data available:

Illinois has a managed care program called the Managed Care section of the Illinois Department of Healthcare and Family Services (HFS) website.

This program is part of the state's healthcare system, aiming to improve patient outcomes and reduce healthcare costs.

The Illinois Department of Healthcare and Family Services is responsible for overseeing the managed care program, ensuring it meets the state's healthcare needs.

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Lehigh Capital Counties in Illinois have a similar program to HealthChoices, but it's actually located in Pennsylvania. Lehigh Capital Counties in Pennsylvania include Adams, Berks, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry, and York.

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If you live in one of these counties, you can choose from several health plans. AmeriHealth Caritas Pennsylvania is one of the options, and you can reach their member services by calling 888-991-7200 or TTY 888-987-5704.

Geisinger Health Plan is another choice, and you can reach their member services by calling 855-227-1302 or TTY 711. They also have a special needs unit that you can contact at 855-214-8100 or TTY 711.

Health Partners Plans is a third option, and you can reach their member services by calling 800-553-0784 or TTY 711. Their special needs unit can be reached at 866-500-4571 or TTY 711.

If you prefer Highmark Wholecare, you can reach their member services by calling 800-392-1147 or TTY 711. Their special needs unit can be reached at 877-392-1147 or TTY 711.

UPMC for You, Inc. is the final option, and you can reach their member services by calling 800-286-4242 or TTY 711. Their special needs unit can be reached at 866-463-1462 or TTY 711.

Here are the health plans and their contact information in a table:

If you're living in Southeast Counties in Pennsylvania, you're part of the HealthChoices Program.

The HealthChoices Program is managed by multiple health plans, including Geisinger Health Plan, Health Partners Plans, Keystone First, UnitedHealthcare Community Plan, and UPMC for You, Inc.

Each of these health plans has its own phone number for member services and special needs units.

Here are the phone numbers for member services:

Similarly, each plan has its own phone number for special needs units.

Here are the phone numbers for special needs units:

The Southwest Counties in Illinois' HealthChoices Program include Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington, and Westmoreland. These counties have access to various health plans and services.

AmeriHealth Caritas Pennsylvania is one of the health plans available in these counties, offering member services at 888-991-7200 and special needs units at 800-684-5503.

Geisinger Health Plan is another option, providing member services at 855-227-1302 and special needs units at 855-214-8100.

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Health Partners Plans offers member services at 800-553-0784 and special needs units at 866-500-4571.

Highmark Wholecare is also available, offering member services and special needs units at 800-392-1147.

UPMC for You, Inc. provides member services at 800-286-4242 and special needs units at 866-463-1462.

Here is a list of the health plans available in Southwest Counties:

HealthChoice Illinois (HCI) is a program that offers comprehensive health insurance to eligible individuals. It's managed by the Illinois Department of Healthcare and Family Services (HFS).

In FY 2022, HFS held contracts with five managed care plans to serve the HCI population. These plans include Families and children, Adults eligible for Medicaid under the Affordable Care Act, Seniors and adults with disabilities who are not eligible for Medicare, and Dual Medicare-Medicaid eligible adults receiving certain Long Term Services and Supports.

The HCI program covers a wide range of benefits, but MLTSS customers receive some long term services and supports, along with some mental health and transportation services, from their HCI health plan. All other services for MLTSS customers are covered by Medicare and Medicaid fee for service.

You can find more information about the MCOs operating in the HCI program on the Managed Care map.

Here are some contact details for the managed care plans operating in HCI:

In California, the California Association of Health Plans oversees several regional programs, including the California HealthCare Foundation's CareMore program, which provides managed care services to Medicare and Medicaid beneficiaries.

The CareMore program in California has a network of over 10,000 primary care physicians and specialists, ensuring that patients have access to quality care.

In Florida, the Florida Association of Health Plans has established several regional programs, including the Florida Blue Health Options program, which offers managed care services to individuals and families.

Florida Blue Health Options has a network of over 25,000 healthcare providers, including primary care physicians, specialists, and hospitals.

In New York, the New York State of Health has implemented several regional programs, including the Essential Plan, which provides managed care services to low-income individuals and families.

The Essential Plan in New York covers a wide range of healthcare services, including doctor visits, hospital stays, and prescription medications.

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In Texas, the Texas Association of Health Plans has established several regional programs, including the Blue Cross and Blue Shield of Texas program, which offers managed care services to individuals and families.

Blue Cross and Blue Shield of Texas has a network of over 40,000 healthcare providers, including primary care physicians, specialists, and hospitals.

In Illinois, the Illinois Association of Health Plans has implemented several regional programs, including the IlliniCare Health Plan, which provides managed care services to Medicaid beneficiaries.

IlliniCare Health Plan in Illinois has a network of over 5,000 primary care physicians and specialists, ensuring that patients have access to quality care.

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