Every 4 to 5 years, Arizona goes to bid on Medicaid contracts. These are the insurance companies that bid to serve people on the state Medicaid system. Hundreds of thousands of lives are in transition as carriers negotiate contracts to serve these clients. Every 4-5 years, carriers win contracts to manage this population.
What This All Means & Timing
- Certain Counties will be awarded and lost for certain carriers.
- Carriers that lose a bid, will be moved to a new Medicaid company (not MAPD plan).
- Clients losing their Medicaid provider might need to locate a new MAPD plan.
- Awards were just announced 3/5/18.
- Contracts and most major changes start 10/1/18.
- Depending on the carrier, and if a filed D-SNP MAPD plan exists, marketing and enrollment might begin as early as 10/1 using SEP or AEP codes.
- 11/1, 12/1 and 1/1 will be the key dates to enroll potential clients.
- Many clients might still be on the plan of choice; if their current Medicaid contract and D-SNP plan stay in place.
- Magellan is the only new bidder in the program.
The Big Opportunity
- You have the opportunity to be in the community, helping people find new plans.
- You have an opportunity to educate local communities on the changes; be a source of contact.
- Thousands of clients all over the state might need to find a new plan.
- If you are invested or investing in the Medicare D-SNP membership growth, start your planning!
- Professionals with a strong community event filed presence are likely to win big.
Changes Effective 10/01/2018 – Members to Make New Elections in July
Arizona’s state Medicaid system awards Geographical Service Areas to Managed Care Organizations. Effective 10/01/2018, approximately 300,000 members will transition to a new MCO in their geographic area. Members will be notified of their new health plan assignment in June and will be allowed to make changes to their assignment during the month of July.
| Geographic Service Areas (GSA) | Geographic Service Areas (GSA) |
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Central GSA
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South GSA
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North GSA
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WAP D-SNP Portfolio
- Make sure you have all the D-SNP power in your bag for this opportunity.
- WAP’s current D-SNP portfolio:
- United Healthcare – Central & Pima (We are an FMO)
- Health Choice – Central & North (We are an FMO)
- University of Arizona – Central & South (We are an IMO/FMO)
- *Each of these carriers are unique and offer value. We’ve got the state covered! If you are not yet appointed, contact us for appointment and certification instructions at Contracting@WesternAssetProtection.com; if you work with an agency partner, direct your request through them.
- WAP is pursuing a relationship with: Centene/Health Net but have not formally signed any agreements. More on this soon.
Additional Resources:
- Click HERE for the update on Arizona’s Medicaid website.
- Click HERE for the update on timing of the changes on Arizona’s Medicaid website.
Watch Your Email for an Upcoming Webinar
In the next couple of weeks, we will host a webinar to discuss these changes and the huge opportunity it presents for all of you. Stay tuned!