Health Plan Open Enrollment

Managed Care Open Enrollment

 

Rural health plan questions and answers

Last updated 10/7/2025

 

Open Enrollment for Managed Care Health Plans runs from October 1, 2025, to December 26, 2025.
If you choose a new health plan during this time, it will start on January 1, 2026. Managed care health plans will be available statewide starting on January 1, 2026.  Managed Care has groups of doctors and other medical providers enrolled for member care and must use them for health services. Approximately 70,000 Nevadans currently enrolled in a Fee-for-Service model of Medicaid are expected to qualify. Here is how statewide managed care will be rolled out. Enrollees will receive letters starting October 2025  explaining the change, and it will explain how to choose a managed care plan during Open Enrollment dates, October 1 through December 26, 2025. You can also change plans using the NVMedicaid App. All plans cover the same basic services. But they might have different doctors, and they have different free extra benefits.

STEP 1: How to decide which plan is best for you

  • Look at the free extra benefits that each plan offers here: https://dhcfp.nv.gov/Members/BLU/MCOMain/.
  • Ask yourself: What services do I need? Which hospitals, labs and imaging locations do I use and are they in the network?
  • Ask your doctor which networks they are in.
  • Look at what hospitals and clinics are close to you and ask them which health plan networks they are in.
  • Ask the health plans if they will let you fill in prescriptions at the pharmacy you use.
  • Ask the health plans if they offer any special programs to help you stay healthy.

 

STEP 2: How to change health plans

Members can change to a different managed care health plan when they get the open enrollment letters from Medicaid starting in October 2025 through December 26, 2025. To choose a health plan, follow one of the steps below:

  • Use the NVMedicaid App
  • Send an email to nvmmis.mco@GainwellTechnologies.com
  • Or mail the form you get in the mail to NV Medicaid, MCO Changes, P.O. Box 30042, Reno, NV 89520. Make sure to include all household members with Medicaid ID # and the plan you choose.

If you need another form, you can find it here. Change requests can be received until March 31,2026. You can also change plans during the next open enrollment October 1, 2026. If you choose a new health plan during Open Enrollment and you want to make a different choice, you have 90 days from January 1, 2026, to change plans one more time. You can use this 90-day change form and submit it according to the instructions in the form. After that, members will stay in their health plan until the next Open Enrollment in October 2026. Please do not send multiple requests to change unless it is a second time before January 1, 2026.. You have a choice during open enrollment October-December 2025.

 

Questions? Call (866) 569-1746 (TTY: 7-1-1), or email @ medicaid@nvha.nv.gov.

Apply for Medicaid at Access Nevada at https://accessnevada.dwss.nv.gov/public/landing-page.

People who don't qualify for Medicaid can shop for health insurance at Nevada HealthLink.com

Managed Care