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December 2016 Texas Medicaid Provider Procedures Manual

Section 4: Client Eligibility : 4.1 General Medicaid Eligibility : 4.1.9 Medicaid Managed Care Eligibility

4.1.9
All clients who are determined to be eligible for Texas Medicaid are first enrolled as fee-for-service clients. Specific client groups within the Texas Medicaid population are eligible for managed care based on criteria such as age, location, and need. A client who is determined to be eligible for Medicaid managed care is enrolled in the appropriate managed care organization (MCO) or dental plan with a separate eligibility date. In most cases, Medicaid managed care enrollment is not retroactive.
Refer to:
The Medicaid Managed Care Handbook (Vol. 2, Provider Handbooks) for more information about managed care eligibility and enrollment.

Texas Medicaid & Healthcare Partnership
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