ANNAPOLIS – Garrett County Medicaid recipients will still be able to participate in managed care this January, officials confirmed Tuesday, thanks to United HealthCare’s decision to expand service into the county.
United’s move – not yet official – will make up for the loss of Priority Partners, another managed care group, which this year announced a statewide enrollment freeze effective Jan. 1.
Priority Partners’ freeze left just one group, Maryland Physicians Care, open to new HealthChoice customers in the county next year. That would have eliminated the program for new Medicaid clients in Garrett.
The HealthChoice managed care Medicaid program requires at least two managed care groups with open enrollment to operate in a jurisdiction for new recipients have a true choice of care programs.
“Garrett was the only county with only two (managed care organizations),” said Susan Tucker, Office of Health Services executive director. “So that was the one everybody worried about when Priority froze.”
Early this month, United HealthCare representatives told Tucker and other Department of Health and Mental Hygiene officials they would move into Garrett as an open-enrollment insurer.
To become a formal Garrett County HealthChoice insurer, United must make sure it has contracted with enough caregivers in the area to provide good coverage to county Medicaid clients.
“It’s never easy in the rural areas . . . It’s possible in the end we won’t be able to come up with the appropriate network,” said United spokeswoman Barbara Spence. “On the other hand, we’re optimistic enough that we’re going to try.”
United already serves about 60 Garrett HealthChoice members who’ve elected to find out-of-county care, Spence said, so it shouldn’t be difficult to develop a network to take on new enrollees.
“We’re a very established, large insurance company in general, and we’ve been in HealthChoice since (its) beginning,” Spence said. “So we’ve already got . . . enough of a network in place to support 60 enrollees in Garrett who picked us in spite of the fact that we’re not officially in Garrett.”
Maryland Physicians Care manages health care for the majority of Garrett’s 4,100 HealthChoice clients, and Priority Partners will continue to care for in- county members already enrolled, DHMH officials said.
“I don’t think it will be a huge enrollment by any means” for United, said spokeswoman Spence.
Managed care groups must give the state 60 days notice before freezing enrollment in an area. Statewide, Priority Partners and another HealthChoice insurer, Helix Family Choice, are the only groups to have announced a freeze for next year.