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The Open Enrollment season is almost over. At a time of year when many Virginians are thinking about their health care needs for 2021, we want to make sure you have all of the information you need to help them make the best choice.
Current Medicaid members may be eligible to select a new plan that better fits their needs. Virginians looking for health coverage can explore their options on the Federal Marketplace or check their Medicaid eligibility.
What is Medicaid Managed Care Open Enrollment?
Health care advocates are important partners in helping Virginians understand the different types of open enrollment that happen each fall. For Medicaid managed care members, open enrollment is the time each year when they have the option to change health plans for any reason.
We encourage members to review the added benefits and provider networks available with each of the six Medicaid managed care health plans so they can select the one that best meets their needs. Of course, if they like their current plan, they do not need to do anything.
The open enrollment schedule is different for Medicaid members in Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus). Members who are unsure about their program assignment or open enrollment timeframe should check to see if their open enrollment letter is on yellow paper or white paper. Yellow paper indicates Medicaid expansion members. Members who receive their letter on white paper should look for the program name of either Medallion or CCC Plus and follow the directions below.
Here is a refresher on the process for the two programs:
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Commonwealth Coordinated Care Plus
(CCC Plus)
Members in original CCC Plus eligibility categories have an open enrollment period of October 1 through December 18, 2020. For members in CCC Plus who became eligible for coverage because of Medicaid expansion, open enrollment is from November 1 through December 18, 2020. All members receive an enrollment letter that lists the dates of their open enrollment period.
Here is a to-do list for open enrollment:
- Review the added benefits from all six health plans
- Ensure health care providers participate in the health plan’s network
- Members in CCC Plus can go to cccplusva.com for more information or to select a new health plan
- Call the CCC Plus Enrollment Helpline to ask questions at 1-844-374-9159 (TTY: 1-800-817-6608), between 8:30 a.m. – 6 p.m. Monday through Friday. Interpreter services are free.
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Medallion 4.0
For members in the Medallion 4.0 program who became eligible for coverage because of Medicaid expansion, open enrollment is from November 1 through December 31, 2020, in all regions of the state. Members in other eligibility categories who live in the Southwest and Roanoke/Alleghany regions are next and have an open enrollment period of December 19, 2020, through February 28, 2021. Members in other regions can check their enrollment letters to find the date of their open enrollment period. They can also view the dates for each region by visiting https://www.virginiamanagedcare.com/learn/open-enrollment.
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Medicaid members and advocates can download the MEDALLION App, which allows members to choose a health plan or to find a doctor!
- Download the free MEDALLION App on your Android or iPhone. Search for Virginia Medallion on Google Play or the App Store.
- Read the comparison chart that comes with each open enrollment letter.
- Review the added benefits from all six health plans to see what best meets the member’s needs.
- Members may change their health plan the following ways:
- Click on the MEDALLION App. Use the member’s Medicaid ID and Date of Birth to login.
- Go to VirginiaManagedCare.com.
- Call the Managed Care Helpline at 1-800-643-2273 (TTY: 1-800-817-6608). Open Monday through Friday, 8:30 a.m. to 6:00 p.m. Interpreter services are free.
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Open Enrollment on the Federal Marketplace ends December 15, 2020. Virginians looking for health coverage can create a Marketplace account to explore options in their area and enroll in coverage. Plans are comprehensive and affordable, covering doctor's visits, x-rays, prescription drugs and other health care needs. 84% of Virginians who enrolled in 2020 Marketplace coverage received financial assistance, which brought their average monthly health care bill down to $94 per month.
Learn more about Open Enrollment on the Federal Marketplace.
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