Managed Care

What it means

A type of health insurance where a private company manages a member's care. In New York, most Medicaid recipients must choose a managed care plan (like Fidelis, Molina, UnitedHealthcare, Excellus). The plan coordinates care: each member gets a primary care doctor (called a PCP), and may need a referral from the PCP to see a specialist. The plan covers the same services as regular Medicaid — doctor visits, hospital, prescriptions, dental, vision, mental health — but the member uses the plan's network of providers. A recipient who does not choose a plan is auto-assigned to one. Plans can be switched during open enrollment or within 90 days of enrollment.

When you might hear this

You hear this when you sign up for Medicaid in New York. Most Medicaid recipients are enrolled in a managed care plan — a private insurance company that manages your benefits. You pick a plan, and the plan assigns you a primary care doctor.

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