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Choosing a health plan

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You choose the type of health plan you want. We offer these 3 types of plans: 

Accountable Care Organizations 

Accountable Care Organizations (ACOs) are groups of doctors, hospitals and other health care providers who work together to coordinate your care. 

In an ACO, your primary care provider (PCP) and their team work with you and your ACO's network of providers. Your PCP knows your needs and works with you directly to make decisions about your care. Your PCP also connects you with services and supports. They help you get the right care at the right time.

There are 2 types of ACOs you can enroll in: Accountable Care Partnership plans or Primary Care ACO plans.

Accountable Care Partnership plan

In this type of ACO plan, a group of PCPs work with one Managed Care Organization (MCO). They form a network of PCPs, specialists, behavioral health providers, and hospitals. PCPs plan and coordinate care to meet your health care needs.

In an Accountable Care Partnership plan, you:

  • Must live in the ACO service area
  • Must use the plan’s provider network
  • Must choose a PCP, or one is assigned to you
  • Can change your PCP within your plan at any time
  • Have a plan selection period and a fixed enrollment period
  • May get behavioral health or long-term services and supports (LTSS) from a Community partner

Primary Care ACO

This type of ACO is also a group of PCPs who have joined together in an ACO to give you primary care. The Primary Care ACO contracts directly with MassHealth to give members primary care and coordinate services. Primary Care ACOs work with specialists and hospitals in the MassHealth network. You also have direct access to providers in their “referral circle.” The Massachusetts Behavioral Health Partnership (MBHP) provides behavioral health services.

In the Primary Care ACO, you:

  • Must choose a PCP, or one is assigned to you
  • Can change your PCP within your plan at any time
  • Have a plan selection period and a fixed enrollment period
  • May get behavioral health or long-term services and supports (LTSS) from a Community partner

Managed Care Organizations 

Managed Care Organizations (MCOs) are health plans run by insurance companies. They provide care through their own network. Each MCO’s network includes PCPs, hospitals, behavioral health providers, and specialists. The care coordinators work for the MCO.

If you choose an MCO plan, you cannot choose a PCP who is part of an ACO.

With an MCO, you: 

  • Must live in the MCO service area
  • Must use the MCO network of providers
  • Must choose a PCP, or one is assigned to you
  • Can change your PCP within the MCO's network at any time
  • Have a plan selection period and a fixed enrollment period
  • May get behavioral health or long-term services and supports (LTSS) from a Community partner

Primary Care Clinician (PCC) plan 

The Primary Care Clinician (PCC) plan is a statewide managed-care health plan for MassHealth members.  In the PCC plan, primary care providers (PCPs) are called Primary Care Clinicians (PCCs). The MassHealth network of PCCs, specialists and hospitals delivers services. The Massachusetts Behavioral Health Partnership (MBHP) provides behavioral health services. They work with MassHealth to give you care.

If you choose the PCC plan, you cannot choose a PCP who is part of an ACO plan to be your PCC.

In the PCC plan, you:

  • Must choose a PCC from the MassHealth list, or one is assigned to you
  • Can change your PCC at any time
  • Can change from the PCC plan to an ACO or MCO at any time

Learn more about how to choose the best health plan.