• South Carolina Managed Care Health Plans
• Enrollment Counselor Services
• Managed Care Plans Map
• Managed Care Organizations (MCO)
• Medical Homes Network Program (MHN)
• Enrollment Period
• Managed Care FAQS
• Managed Care Supplement
• South Carolina Medicaid Managed Care Pharmacy Information Grid
• South Carolina Managed Care General Drug Request Form
• NEW Healthy Connection Choices by County Map
• NEW HCC Eligibles and Enrolled Members by County
• NEW Managed Care Enrollment Estimates 2009
• NEW Healthy Connection Choices Dashboard

The following links have been removed and the information is contained in the Healthy Connections Dashboard:

Managed care is a health care delivery model implemented to establish a medical home for all Medicaid eligible beneficiaries.

The goals of a medical home include:

Accessible, comprehensive, coordinated, family-centered primary and preventive care.

Provide accessible, comprehensive, family-centered coordinated care

Manage the beneficiary's health care, perform primary and preventive care services, and to arrange for any additional needed care

Provide beneficiaries access to a "live voice" twenty-four hours a day, seven days a week, to ensure access to appropriate care

Provide beneficiary education about preventive and primary health care, utilization of the medical home, and appropriate use of the emergency room

Medicaid beneficiaries now have more choices regarding their preferred health care delivery model. In addition to traditional fee-for-service Medicaid, beneficiaries may choose from two types of Managed Care plans. Those include a Managed Care Organization (MCO) or a Medical Homes Network (MHN). Both models are available statewide and offer enhanced benefits beyond traditional fee-for-service.

In order to operate as a Medicaid managed care provider (MCO or MHN) in South Carolina, the health plans must adhere to a number of state and federal rules and regulations. Federal managed care requirements may be found in Title 42 Section 438 of the Code of Federal Regulations. These requirements can also be found in the SC managed care contracts.

Providers are encouraged to always check eligibility of beneficiaries. This is even more important as more beneficiaries are enrolling in managed care plans.