Managed Care Organization (MCOs)

MCOs are health plans run by insurance companies that provide care through their own provider network that includes PCPs, specialists, behavioral health providers, and hospitals. For individuals choosing an MCO, a PCP must be within the network for coverage, and the member must live in the service area.  This makes it easier for the member to stay connected to their provider. If for some reason the member would like to switch to another health plan, they can do so during their annual 90-day plan selection period. If the member is in their fixed enrollment period, they are only permitted to change to a new health plan for specific reasons.  For more information about MCOs and their service areas, please visit MassHealthChoices.com.  

 

Enrollment is open to members who meet the following criteria:

  1. Under 65 with MassHealth as their only insurance

  2. Living in the community (not a nursing home)

  3. In MassHealth Standard, MassHealth CommonHealth, MassHealth CarePlus, or MassHealth Family Assistance

  4. Living in the service area of the plan

There are currently two MCO options for MassHealth members

  • Boston Medical Center HealthNet Plan

  • Tufts Health Together