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  Home >> Bureau of Health Services and Delivery Systems >> Managed Care Information >> Enrollment Period

  Enrollment and Disenrollment

 
All managed care enrollment and disenrollment requests are handled through one single point of contact, South Carolina Healthy Connections Choices (SCHCC). SCHCC is a program that assists eligible Medicaid beneficiaries with the selection of, and changes to, their Medicaid health care service delivery system. Choices currently include:

  • Managed Care Organization
  • Medical Homes Network
  • Fee-for-Service
SCHCC should be contacted for assistance with transferring to, or disenrolling from, a health plan regardless of whether the beneficiary is in his 90-day choice period, or lock-in period. SCHCC may be reached by calling 877-552-4642.

Upon enrolling in an MCO or MHN, beneficiaries have 90 days to request a change. Only one change may be requested during this 90-day choice period. Once a choice, or change has been made, or the 90-day choice period ends, all participants remain in their plan for the remainder of the 12-month lock-in period.

Enrollment may be ended during the lock-in period for "just cause", but requires a disenrollment form be completed and returned. A disenrollment form may only be obtained by calling SCHCC.

All disenrollment requests made during the lock-in period are reviewed by the SCDHHS and health care plan in an effort to address and resolve the concerns raised. Health plans have 10 days to respond to and resolve the member's concerns. If the concerns are not resolved, the issue is forwarded to the SCDHHS. Failure to resolve disenrollment requests made during the lock-in period within 60 days results in automatic approval of the member's request.



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