The Mississippi Division of Medicaid has contracts with three Coordinated Care Organizations, who are responsible for providing services to the Mississippi Medicaid beneficiaries who participate in the MississippiCAN program.
All plans offer the same services Medicaid offers. Each plan will offer extra benefits such as vision and physician visits benefits.
The three plans must adhere to all rules found in the Mississippi Administrative Code.
Choosing a Health Plan
When choosing a health plan beneficiaries must know that this is a way to get Medicaid Services. When you are in a health plan you will have your own doctor or clinic.
Choose a Plan that is Best for You
There are three health plans in MississippiCAN. Below are tips for members when choosing a plan:
- Medicaid beneficiaries should choose a health plan that is best for them and meets their medical needs.
- Compare the benefits that each health plan offers.
- Check to see if your doctor and/or hospital accept the health plan.
- You can only see your regular primary care physician or specialist if they accept your plan.
Health Plan Resources
- Magnolia Health brochure
- Magnolia Health website
- UnitedHealthcare brochure
- UnitedHealthcare website
- Molina Healthcare brochure
- Molina Healthcare website
All services currently covered by Medicaid are included but the limits may be different for some services. The health plans will pay for the following:
- Physician Office Visits (more than what Medicaid provides)
- Durable Medical Equipment (DME)
- Vision (more than what Medicaid provides)
- Dental (limited over 21)
- Therapy Services
- Hospice Services
- Pharmacy Services
- MississippiCAN Health Plans must cover all medications covered by regular (fee for service) Medicaid, but may cover additional medications if they choose to do so.
- MississippiCAN Health Plans must use the Universal Preferred Drug List (PDL) and the same prior authorization criteria as regular Medicaid. Your doctor can request prior authorization for non-preferred drugs on the PDL. Your pharmacist may fill a 72 hour emergency supply of non-preferred medications while awaiting prior authorization.
- MississippiCAN Health Plans must cover all over-the-counter (OTC) medications covered by regular Medicaid.
- Mental Health Services
- Outpatient hospital services (Chemotherapy, ER visits, x-rays, etc.)
- Inpatient hospital services
- Non-emergency transportation (NET)
All MississippiCAN beneficiaries must always present your new health plan card and your Medicaid card for all health plan services.
The Coordinated Care Organizations (CCOs) are not required to pay for:
- Long term care services
- Waiver services
Each of the CCOs are required to develop a provider network that includes all types of providers to service our beneficiaries, and must be enrolled as a Mississippi Medicaid provider. Each of the CCOs may subcontract with vendors to provide services (i.e. dental, vision, durable medical equipment, lab, etc.).