Health Plan Open Enrollment

Managed Care Open Enrollment

Medicaid and dental services for recipients living in urban Clark and Washoe counties are delivered by health plans known as Managed Care Organizations (MCOs). New Managed Care enrollees have 90 days from the date of enrollment to make a change to their MCO before being locked in until Medicaid Managed Care Open Enrollment.  

Managed Care Open Enrollment is the period once a year that enrolled members can change MCOs. It occurs once a year from October 1st through October 31st for all Nevada Medicaid recipients who are enrolled in an MCO.  

An open enrollment letter is mailed to all active managed care head of households beginning the first week in July of the current year and if the household wishes to switch to another MCO the head of household will need to submit the change request.

  • You can request a switch upon receipt of your letter. All Open Enrollment change requests must be received by October 31st of the current year and will be effective January 1st of the following year.
  • Open Enrollment change requests received after October 31st of the current year will not be honored as the Open Enrollment period has ended.
  • Recipients will have 90 days from the effective date to make one (1) final MCO change. Once this final change has been processed, the household will remain in the selected MCO until the next open enrollment period.
  • The head of household needs to send the Open Enrollment request to: Nevada Medicaid Attn. MCO Changes P.O. Box 30042 Reno, NV, 89520 or by email (preferred method) to NVOpenEnrollment@gainwelltechnologies.com
  • Recipients may contact the Medicaid District Offices with any questions at: Southern Nevada: (702) 668-4200 Northern Nevada: (775) 687-1900.
  • The request requires the recipient to fill in their Medicaid ID number if not already on the form and to select the new MCO.
  • Please do not submit multiple requests. Only one form needs to be submitted unless you would like to change a previous choice. The last change request received is the choice that will be honored. 
  • The Open enrollment packet will include the Update your address flyer front and back and the NVMedicaid app flyer front and back. The letters will include links to each MCO and the Division of Health Care and Financing Policy (DHCFP) Managed Care website for recipients to view each MCO Benefit Fact Sheets, therefore we are no longer mailing out the Benefit Fact Sheets. To view the MCO Benefit Fact Sheets click on the following link: https://dhcfp.nv.gov/Members/BLU/MCOMain/.
If you are not currently enrolled in Nevada Medicaid and would like to see if you qualify, please visit Access Nevada athttps://accessnevada.dwss.nv.gov/public/landing-page.

 

For information about Nevada Health Link Open Enrollment, please visithttps://www.nevadahealthlink.com/start-here/how-to-enroll/open-enrollment/.

    Managed Care