Mandatory Passages and Language for MC+ Managed Care Health Plan Handbook

GLOSSARY

Adoption Subsidy: Subsidy services supporting a family adopting a child. Financial, medical, and support services for the child until age 18 or in some cases until age 21. These children may choose to get their health care as an MC+ Managed Care health plan member, or may choose to get health care through MC+ Fee-for-Service using MC+ approved providers.
Advance Directive: An advance directive allows you to leave written directions about your medical treatment decisions and/or ask someone to decide your care for you.
DCN: Departmental Client Number - also known as your MC+ health number. This is your identification number for MC+.
Eligibility Group: Members who receive benefits based on age, family size, and income.
EPSDT: Early Periodic Screening, Diagnosis, and Treatment, also known as HCY.
HCY Program: Healthy Children and Youth, also known as EPSDT.
MC+ Approved Provider: A doctor, nurse, clinic, pharmacy, hospital, or other providers enrolled with the MO HealthNet Division as an MC+ approved provider. MC+ approved providers provide services in the MC+ Fee-for-Service program. You will show them your red MC+ card. MC+ approved providers are sometimes also called MO HealthNet providers. You can do an on-line search to find an MC+ approved provider or you can call 1-800-392-2161 for a list of MC+ approved providers
MC+ Fee-for-Service: A way to get some health care services that are not covered by your health plan. These services may be covered by MC+ Fee-for-Service. You can go to any approved provider that takes MC+ Fee-for-Service. Use only your red MC+ card. You may call 1-800-392-2161 to check on how to get these services.
MC+ Managed Care: A way to get your MC+ coverage from a MC+ Managed Care health plan in certain counties of the State. You must choose a MC+ Managed Care health plan or one will be chosen for you. You must also choose a Primary Care Provider. Use your MC+ Managed Care card and your red MC+ card to get services. While you are waiting to get in a MC+ Managed Care health plan for health care, you get services from MC+ Fee-for-Service. There are a few services that members in a MC+ Managed Care health plan will receive from MC+ Fee-for-Service. You may call 1-800-392-2161 to check on how to get services.
MC+ Managed Care Card: The card sent to you by your MC+ Managed Care health plan.
Out of Home Care/Alternative Care Services (Foster Care): Alternative Care is the care of children living in a home other than their birth parents. The juvenile court removes the child from their home. The Children's Division then sets a plan of services.
PCP: A Primary Care Provider is a health care provider who manages a member's health care.
Prior Authorization: Your MC+ Managed Care health plan's method of pre-approving certain services.
Red MC+ Card: The card sent to you when you are eligible for MC+.
Referrals: A process used by a PCP to let you get health care from another health care provider, usually for specialty treatment. Some health plans do not require referrals to see a specialist that is in the health plan's network.

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