Integrated Behavioral Health and Primary Care
Frequently Asked Questions (FAQs)
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Will Title XIX individuals with an SMI determination who have only Medicare Part A and Medicare Part D be eligible to enroll in the new RBHA?
No. Those with an SMI determination and Medicare Part A and Part D will not be eligible to enroll in Mercy Maricopa for Medicare. Individuals must have Medicare Parts A and B to enroll in a Medicare Advantage plan such as Mercy Maricopa, beginning January 1, 2014. Members with an SMI determination and Medicare Part A and Part D will be enrolled with Mercy Maricopa for Medicaid.
Will Title XIX individuals with an SMI determination be able to enroll in the Maricopa RBHA for Medicare?
Mercy Maricopa is required to be a Medicare plan beginning January 1, 2014. AHCCCS-eligible individuals:
- with SMI; and
- that are enrolled with Mercy Maricopa for Medicaid physical and behavioral health; and
- that have Medicare Parts A and B
will be able to enroll with Mercy Maricopa for Medicare and have one point of contact for all services, questions and care coordination.
If a SMI member is dually eligible (Medicare & AHCCCS), how will this impact the member's flexibility in health plan choice? Since AZ isn't moving forward with the dual demonstration, how will this impact a member who is dually eligible? How does it impact co-payments for that dually eligible member?
Members will still be able to enroll in a Medicare Advantage plan or Original FFS Medicare. Medicare Parts A and B co-payments, deductibles, and coinsurance will be paid for by Mercy Maricopa. Mercy Maricopa will be a Medicare plan beginning January 1, 2014. Members are encouraged to talk to Mercy Maricopa about enrolling in their Medicare plan. By enrolling in Mercy Maricopa's Medicare plan members will receive:
- medical care,
- behavioral health services, and
- prescription drugs through one health plan, like this one.
Will there be designated contacts for Medicare questions?
Please send your questions to DBHS through the various methods available (see handout on how to stay informed). Mercy Maricopa will soon have designated staff to respond to questions specific to Medicare. Stay tuned for details.
How will the new RBHA in Maricopa County be different starting October 1, 2013?
The RBHA in Maricopa County will be responsible for providing physical health in addition to behavioral health services for certain individuals with serious mental illness. For specific details, view this fact sheet.
Why is the RBHA in Maricopa County changing?
The RBHA in Maricopa County is changing to make it easier for individuals with a serious mental illness to access their physical and behavioral healthcare through one health plan.
What if I don't have Serious Mental Illness but I am getting behavioral health services through the Maricopa County RBHA, will there be a change for me?
Services will remain the same for individuals receiving services through the Maricopa County RBHA who do not have a serious mental illness.
If I have serious mental illness, will I lose my current primary care doctor
If your PCP is not in the Mercy Maricopa network, Mercy Maricopa may negotiate a single case agreement with your PCP if he or she is willing to do so. Mercy Maricopa will allow members to remain with their PCP for 90 days after 10/1/2013. Mercy Maricopa will make all efforts to contract with individuals existing PCPs so that they can continue receiving services from them on an ongoing basis after the first 90 days. Each eligible individual will be provided with multiple choices related to how they want to access integrated care. If your PCP is not in the Mercy Maricopa network and is not willing to contract with MMIC for a single case agreement, you will have 90 days to work with your PCP in transitioning to another PCP in Mercy Maricopa's network.
I read that Mercy Maricopa is connected with a couple of faith based providers. Will this affect me if I don't share the same faith-based beliefs?
While Mercy Care's sponsors are faith-based, Mercy Maricopa will contract with a wide variety of providers without regard to religious preference and values the belief systems of all of its members. Mercy Maricopa will embody the diversity and cultural competency standards set out by the Arizona Department of Health Services/Division of Behavioral Health Services.
What if I am a non-title 19 SMI member currently getting behavioral health services through the Maricopa County RBHA, will there be a change for me?
Adult Non-Title 19 Members who have SMI will continue to receive the same behavioral health services that are currently available to them.