For the 70,000 Medicaid recipients that live in the 15 rural counties (outside of Washoe and Clark) in Nevada, Medicaid is changing from a fee-for-service (FFS) model to managed care organizations (MCO). MCOs are private health care companies that work within a provider network, similar to alternate Medicare HMO options, and have been used by Medicaid users in Washoe and Clark counties since the late 1990s.
Medicaid is a joint federal and state public health program that provides free or low-cost health insurance for low-income households, and currently services people of all ages, including children, pregnant women, seniors (even on Medicare), caregivers and disabled persons, to name a few demographic groups, if they meet eligibility requirements.
In October of this year, a letter was mailed out informing affected Medicaid users of the upcoming changes, and the need to enroll in a MCO (either SilverSummit or CareSource) by December 26 or they would be assigned an MCO. Another letter was mailed this December letting recipients know their assigned MCO if they didn’t already enroll, and that a grace period to switch providers if they want would extend from December 26 to March 31, 2026…