The State enrolls all non-institutionalized Medicaid beneficiaries including the dual eligibles into the Partnership. Dual eligibles must enroll in the Partnership to receive their Medicaid-only benefits such as pharmacy and transportation. They do not have to choose a primary care provider within the partnership network and retain their Medicare freedom of choice. The standard Medicaid benefit package is offered to all participants. Once eligible, the beneficiaries are automatically enrolled in the partnership serving their area.
Eligibility is guaranteed only for the initial six months period of eligibility.
Beneficiary disenrollment is effective on the date specified by the State. The Partnership is a coalition of medical providers from both the public and private sectors. The public sector providers include the local health departments and Federally Qualified Health Centers. Provider networks include hospitals, physicians, pharmacies, emergency transportation, and other providers to ensure the covered services are available within each Partnership. The State is required to include in their quarterly report the reasons that beneficiaries request disenrollment.