If you are enrolled in Medicaid, you must renew once a year or you will lose your coverage.

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How to Choose a Managed Care Organization (MCO)

While completing your Maryland Medicaid application, you will be asked to choose a Managed Care Organization (MCO). Make sure to select Maryland Physicians Care. If you do not select an MCO when you apply, you will automatically be assigned one.

You can apply for Medicaid:

When you apply for Medicaid, you will be asked to choose Managed Care Organization (MCO). Make sure to select Maryland Physicians Care.

What is a Managed Care Organization?

A Managed Care Organization (MCO) is a health plan with a group of doctors and other providers who work together to provide your care as a member.

Your Maryland Medicaid MCO provides much more than seeing a doctor when you are ill. Your Medicaid MCO also offers:

  • Well care for you, your children, pregnant women, and babies
  • Skilled Nursing ServicesHelp to choose doctors
  • Information about how to get rides to doctor visitsInformation to help you learn about specific health topics
  • Answers to your medical questions
  • Assistance with other questions

Understand What Is Covered

It’s important to understand the benefits and services covered in your Maryland Medicaid MCO selection. For example, you’ll want to know:

Are dental services covered?

Maryland Medicaid MCOs may offer adult dental services, although coverage can differ from MCO to MCO. MCOs typically provide preventative, diagnostic, and restorative services to adults between 21 and 64. Children under 21 can receive dental care directly from Maryland Medicaid.

Maryland Physicians Care (MPC) dental care for adults includes:

  • Free exams and cleanings two times a year
  • X-rays, fillings, and extractions are covered under a $750 maximum benefit
  • 20% off non-covered dental services

How about vision and eyeglasses?

Maryland Medicaid MCOs may offer additional benefits for adult vision and eye care not covered by the HealthChoice Program (a Maryland Medicaid program).

Maryland Physicians Care offers the following vision benefits:

Free vision care for adults (age 21 and older)

  • One eye exam every year
  • One set of glasses or contact lenses every two years
  • One pair of lenses every year (when needed)

Free vision care for children (age 20 and under)

  • One eye exam and set of glasses every year
  • One set of contact lenses (when medically necessary)

Does the MCO have the doctors, hospitals, and specialists you use?

The Maryland Physicians Care provider directory is a list of physicians, hospitals, and other healthcare providers available to MPC members. To start your search, click here.

Do you need a Primary Care Provider (PCP) who speaks a certain language?

When searching for a health care provider, use the “Language Spoken” drop down to sort by preferred language.

Does anyone in your family have special needs?

If you or a family member is in a special needs population, you can receive additional services to receive the right type of care.

MPC has a Special Needs Coordinator on staff to provide education on conditions and support services. A case manager may also be assigned when you select Maryland Physicians Care. This person will help develop a patient-centered plan that addresses the treatment services needed.

Is Urgent Care covered?

Services and care from an urgent care facility to treat and stabilize an urgent medical need are covered under Medicaid and the MCO.

MPC has several urgent care centers in its network. For convenient virtual doctor visits seven days a week and no appointment needed, visit MyVirtualMPC and see how easy it is to connect to a doctor.

Do I have a co-pay?

Most services do not have copays. In Summer 2022, Maryland Medicaid requires all MCOs to charge members a copayment on retail pharmacy services.

What about prior authorizations?

MPC members have access to an online web portal that allows access to view claims and prior authorizations, all in real-time. Maryland Physicians Care (MPC) extends the full benefits of the Maryland Department of Health’s (MDH) HealthChoice program (a Medicaid program). MPC also offers additional benefits for adult vision and eye care and adult dental services not covered by the HealthChoice Program (a Maryland Medicaid program), along with many other benefits. Click here for a full list of MPC Benefits.

Check Who Your Current Doctor Works With

If you want to stay with your current doctor, you’ll need to find out which MCO he or she is currently with. The ability to stay with their current physician is important to many people, so you’ll want to see if you can continue to see him or her.

Maryland Physicians Care has a comprehensive network of medical providers, so there is a good chance that your doctor is part of our network. You can use this Find A Provider tool to find your doctor by name, specialty, or location.

How to Choose a Maryland Medicaid MCO

When you apply for Medicaid, you will be asked to choose Managed Care Organization (MCO). Make sure to select Maryland Physicians Care.

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