What is a managed care option (MCO)?

A Managed Care Organization (MCO) is a health plan that contracts with MassHealth to provide and coordinate covered health care services for enrolled members through a network of doctors, specialists, hospitals, behavioral health providers, and other participating providers.

Members enrolled in an MCO generally receive most covered services through the plan’s provider network and must follow the plan’s rules for referrals, prior authorization, and other care-management requirements when applicable.

MassHealth offers different managed-care arrangements, and the options available to a member depend on factors such as eligibility category, age, location, and other coverage.