Under this program, all eligible Medicaid beneficiaries will be required to enroll in the program. The enrollees will have the option of choosing from at least two plans. Enrollment for the SSI population is mandatory. There is no medically need program in Delaware. The HBM is responsible for outreach and education of potential eligibles through marketing and promotional activities.
Beneficiaries have one month to select a plan before being assigned to one.
Otherwise, they are randomly assigned to one of the two MCOs. Enrollees are locked-in to their program for 12 months. Delivery System Enrollees need a referral from PCPs to see specialists. The program guarantees eligibility for one year. The Diamond State Health Plan is a fully capitated managed care program.