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Behavioral health provider

Specialists who give services to people who have challenges such as addiction, physical limitations and mental illness. 

Community partners

Community partners are community-based experts who can work with you and your health plan to get and arrange behavioral health and long-term services and supports (LTSS).

If you have a high need for behavioral health or long-term services and supports (LTSS), Accountable Care Organizations (ACOs) and Managed Care Organizations (MCOs) are now able to provide you with support from a community partner.

Fixed enrollment period

A time each year when you cannot change your health plan. To learn more go to Changing your health plan

Health plan 

A group of doctors, hospitals, and other health care providers. They work together to meet your health care needs. To learn more, go to Choosing a health plan

Medically necessary services or supplies

Health-care services or supplies that meet accepted standards of medicine and are needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms. 

Network 

A group of doctors, hospitals, and other health care providers a health plan contracts with to give members medical care. 

Plan selection period

A time each year when you can choose your health plan. To learn more, go to Changing your health plan

Primary care provider (PCP)

A health care provider you choose to give you routine care and refer you to specialists when needed. To learn more, go to Choosing a primary care provider

Service area

Service areas are areas where a health plan accepts members, based on where they live. Each health plan covers a set of services areas. You can choose a health plan only if it is available in your service area or near where you live. When you choose a health plan in your service area, you will use providers in your plan’s network.