Integrated Behavioral Health and Primary Care

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.

Mercy Maricopa is required to be a Medicare plan beginning January 1, 2014. AHCCCS-eligible individuals:

1. with SMI; and
2. that are enrolled with Mercy Maricopa for Medicaid physical and behavioral health; and
3. 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.

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.

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.

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.

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.

Services will remain the same for individuals receiving services through the Maricopa County RBHA who do not have a serious mental illness.

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.

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.

Adult Non-Title 19 Members who have SMI will continue to receive the same behavioral health services that are currently available to them.