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 2021, as well as information on contracting and appointment.

Medicare Advantage

View this information as a web page.

State Availability

Current as of 06/08/2021

AZ IA LA NJ NM TN TX WA

Plan Information

Current as of 07/22/2020

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. The five major types of Medicare Advantage Plans are: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) Plans, Special Needs Plans (SNPs), and Medical Savings Accounts (MSAs). The type of plan may affect prescription drug coverage options, referral requirements, and network restrictions.

Amerigroup Medicare Advantage plans include valuable benefits. Depending on the benefits available in your region, their Medicare Advantage plans may provide coverage for:

• $0 monthly plan premium
• $0 for primary care, doctor and specialist visits
• $0 copays for dental and vision benefits
• $0 copay for preventive care, such as your annual checkup
• Prescription drug copays as low as $0

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

Medicaid

View this information as a web page.

State Availability

Plan Information

Current as of 07/22/2020

Amerigroup is a health insurance partner that offers Medicaid and serves people who are eligible. 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 what area an individual resides.

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.