Amerigroup Contracting & Appointment

Amerigroup is transforming health care with trusted and caring solutions that improve health care access and quality for their members, while proactively reducing the overall cost of care.

Amerigroup believes in a whole person approach that connects members to the services and support they need for physical health, mental health, and substance use. Addressing the needs and preferences of each member is at the heart of what they do every day. They have invested the time and resources necessary to fully understand and serve nearly 5.6 million members in state-sponsored programs across the country.

Wellness, early detection, and prevention are all critical components of an effective health care delivery system. Amerigroup’s commitment to the health and well-being of each member is unwavering. Amerigroup reinvests in communities to reduce gaps in care and services, address chronic health conditions, and promote wellness. They provide members and their families with tools, knowledge, and self-care techniques to help achieve lifelong health.

Amerigroup Products and State Availability

These are Amerigroup's current products and state availability for 2023, as well as information on contracting and appointment.

Medicare Advantage

View this information as a web page.

State Availability

Last reivew date: 06/08/2021

AZ IA LA NJ NM TN TX WA

Plan Information

Medicare Advantage Plans (Medicare Part C) are a form of private health insurance that provides the same coverage as Medicare Part A and Part B (Original Medicare) and may include additional benefits such as dental, vision, and prescription drug coverage.

Plans also offer additional benefits including SilverSneakers memberships, transportation services and online doctor visits at no additional costs. Additional $0 copay plan benefits:

• Dental exams, cleanings, and yearly x-ray.
• Eye exams plus allowance for eyeglasses or contact lenses.
• Hearing exams plus allowance for hearing aids.
• Personal Emergency Response System.
• Allowance to spend on over-the-counter health care items.
• Plans vary by region.

Some information may vary by state. See state-specific information and rates.

Medicaid

View this information as a web page.

State Availability

AZ IA LA NJ NM TN TX WA

Plan Information

Amerigroup is a health insurance partner that offers Medicaid and serves people who meet the eligibility requirements. Medicaid is a health insurance program for individuals with low income. Most people pay very little – and some pay nothing at all for Medicaid.

Medicaid insurance covers things like doctor visits, hospital stays, labs and X-rays. Other benefits, like prescriptions, vision, and dental care, may also be covered, depending on age and location.

What Medicaid covers for Medicare Enrollees

Medicare has four basic forms of coverage:

• Part A- Pays for hospitalization costs.
• Part B- Pays for physician services, lab and x-ray services, durable medical equipment, and outpatient and other services.
• Part C- Medicare Advantage Plan (like an HMO or PPO) offered by private companies approved by Medicare.
• Part D- Assists with the cost of prescription drugs.

Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid (e.g. MSPs, QMBs, SLMBs, and QIs). Medicaid also covers additional services beyond those provided under Medicare, including nursing facility care beyond the 100-day limit or skilled nursing facility care that Medicare covers, prescription drugs, eyeglasses, and hearing aids. Services covered by both programs are first paid by Medicare with Medicaid filling in the difference up to the state’s payment limit.

Amerigroup, Managed Care Organization (MCO) offers Special Needs Plans (SNPs) to those who receive Medicare and Medicaid. These individuals are sometimes referred to as Dual Eligible.

For Dual Eligible members, Medicaid supplements Medicare-covered services by paying for Medicare premiums, members’ cost-sharing requirements and long-term services and supports (LTSS).

Many of the added Amerigroup services make health care more accessible and help individuals live independently in their homes and communities.